Factors affecting decline in renal function and cyst growth in patients with autosomal polycystic kidney disease (ADPKD) are not fully described, particularly in Japan.
This was the first multi-facility, prospective, observational cohort study conducted in ADPKD patients at 14 centers in Japan. Patients in the J-PKD registry were assessed from December 2009 to June 2012 (follow-up until June 2017). Patients’ data including estimated glomerular filtration rate (eGFR) and total kidney volume (TKV) were assessed initially and a maximum of five times annually. Contributing factors to eGFR decline and TKV growth were identified using multiple linear regression analysis.
Of the 340 patients in the J-PKD registry, data analysis was performed for 192 patients in whom serial changes for both eGFR and TKV were obtained. eGFR slope, eGFR change, and TKV change values were as follows: − 2.7 (− 4.2 to − 1.5) (ml/min/1.73 m2/year), − 5.0 (− 9.6 to − 2.3) (%/year), and 4.78 (0.86–8.22) (%/year), respectively. Lower high-density lipoprotein (HDL) cholesterol was an independent predictor of eGFR decline, using both eGFR slope and change (P = 0.04, P = 0.02, respectively), whereas lower hemoglobin and higher uric acid were significantly associated with greater eGFR change only (P = 0.02, P = 0.002, respectively). Younger age and higher fasting blood sugar were independent predictors of greater TKV change (P = 0.01, P = 0.02, respectively).
This real-world study in Japan identified risk factors for renal function decline in ADPKD patients. These included lower HDL cholesterol, lower hemoglobin and higher uric acid for eGFR decline, and youth and higher blood sugar levels for TKV growth.
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This study was supported in part by a Grant-in-Aid for Intractable Renal Diseases Research, Research on rare and intractable diseases, Health and Labour Sciences Research Grants from the Ministry of Health, Labour and Welfare of Japan. Medical writing support, in accordance with GPP guidelines, was provided by Mediwrite Asia Inc Pte Ltd and included editorial and proofreading services. We thank all the participants in this registry and the clinicians who referred their patients and contributed to the clinical data acquisition.
Conflict of interest
Toshio Mochizuki received travel fees and honoraria for lectures from Otsuka Pharmaceutical Co. Toshio Mochizuki and Hiroshi Kataoka belong to an endowed department sponsored by Otsuka Pharmaceutical Co, Chugai Pharmaceutical Co, Kyowa Hakko Kirin Co, and JMS Co. Satoru Muto received travel fees and honoraria for lectures from Otsuka Pharmaceutical Co., Ltd. Shigeo Horie and Satoru Muto belong to an endowed department sponsored by Otsuka Pharmaceutical Co., Ltd., JENESIS Co., Ltd., Nippon Shinyaku Co., Ltd., Shokubunka Co., Ltd., and Rohto Pharmaceutical Co., Ltd..
The study was conducted in accordance with the guidelines written in the Declaration of Helsinki. Ethics committees from each of the 14 institutions approved the study, and the Japanese Society of Nephrology approved the study (No. 6).
Written informed consent was obtained from all individual participants included in the study.
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Uchiyama, K., Mochizuki, T., Shimada, Y. et al. Factors predicting decline in renal function and kidney volume growth in autosomal dominant polycystic kidney disease: a prospective cohort study (Japanese Polycystic Kidney Disease registry: J-PKD). Clin Exp Nephrol 25, 970–980 (2021). https://doi.org/10.1007/s10157-021-02068-x
- Autosomal dominant polycystic kidney disease
- Renal function
- Total kidney volume
- High-density lipoprotein cholesterol