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The predictive value of renal parenchymal information for renal function impairment in patients with ADPKD: a multicenter prospective study

  • Kidneys, Ureters, Bladder, Retroperitoneum
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Objective

Although the guideline indicates that total kidney volume (TKV) is an important detection indicator in patients with autosomal dominant polycystic kidney disease (ADPKD), this study attempted to demonstrate that renal parenchymal information, combined with parenchymal volume and radiomics features, may have more valuable clinical guiding significance.

Methods

A totals of 340 ADPKD patients with normal renal function were prospectively collected and followed-up for five years, with renal function tests and non-contrast computed tomography (CT) performed every six months. The relationship between renal function impairment and renal parenchymal volume (RPV) as along with radiomics features was explored using a multiple linear regression model and multiple logistic regression. Then, a combined model of RPV with radiomics features was constructed to comprehensively evaluate its predictive value.

Results

Compared with TKV, decreased RPV presented a closer relationship with renal function impairment, namely, with the impairment rate (RPV: 82.3% vs. TVK: 67.1%) and eGFR (RPV: r = 0.614, p < 0.001 vs. TKV: r = -0.452, p < 0.001), and showed higher predictive power (RPV: AUC = 0.752 [95%CI 0.692–0.805], p < 0.001 vs. TKV: AUC = 0.711 [95%CI 0.649–0.768], p < 0.001). Correspondingly, the radiomics analysis that was derived from the renal parenchyma also showed a satisfactory result (AUC = 0.849 [95%Cl 0.797–0.892], p < 0.001). Importantly, the predictive power for renal function impairment was further improved in the combined model of RPV and radiomics features (AUC = 0.902 [95%Cl 0.857–0.937], p < 0.001).

Conclusion

Renal parenchyma information may be a sensitive biomarker of renal function impairment in ADPKD, which can provide a new approach for clinically monitoring renal function, and may greatly improve the pre-hospital prevention and treatment effects.

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Abbreviations

ADPKD:

Autosomal dominant polycystic kidney disease

TKV:

Total kidney volume

CT:

Computed tomography

RPV:

Renal parenchymal volume

GFR:

Glomerular filtration rate

Scr:

Serum creatinine

VOI:

Volume of interest

IG:

Impairment group

NIG:

Non-impairment group

ICCs:

Intraclass correlation coefficients

ROC:

Receiver operating characteristic

AUC:

Area under the curve

AI:

Artificial intelligence

DL:

Deep learning

TA:

Texture analysis

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Funding

This work was supported by National Natural Science Foundation of China (81871343); Jiangsu Provincial Key Research and Development Plan (BE2017698, BE2018693); the Natural Science Foundation of Jiangsu Province (BK20181226, BK20171311).

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Author notes

  1. Yuhang Xie and Mengmiao Xu have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Affiliated Hospital of Jiangsu University, No. 438, Jiefang Road, Zhenjiang, 212001, Jiangsu, China

    Yuhang Xie, Mengmiao Xu, Yajie Chen & Yuefeng Li

  2. Department of Central Laboratory, The Fourth Affiliated Hospital of Jiangsu University, No. 20, Zhengdong Road, Zhenjiang, 212001, Jiangsu, China

    Xiaolan Zhu & Yuefeng Li

  3. Department of Radiology, Southeast University Affiliated Zhongda Hospital, No. 87, Dingjiaqiao Road, Nanjing, 210009, Jiangsu, China

    Shenghong Ju

Authors
  1. Yuhang Xie
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  4. Xiaolan Zhu
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Contributions

All authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: YX, MX, XZ, SJ, YL. Acquisition of data: YX, MX, YC. Analysis, interpretation of data, and drafting of the manuscript: YX, MX, XZ, SJ. Critical revision of the manuscript for important intellectual content: all authors. Obtained funding: YL.

Corresponding authors

Correspondence to Xiaolan Zhu, Shenghong Ju or Yuefeng Li.

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The authors declare no competing interests.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The local Institutional Review Board approved this study and written consents were obtained from all participants after they received a complete and detailed description of the study.

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Xie, Y., Xu, M., Chen, Y. et al. The predictive value of renal parenchymal information for renal function impairment in patients with ADPKD: a multicenter prospective study. Abdom Radiol 47, 2845–2857 (2022). https://doi.org/10.1007/s00261-022-03554-w

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  • DOI: https://doi.org/10.1007/s00261-022-03554-w

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