Understanding how a patient’s condition will progress is extremely important in providing them with the best treatment, and autosomal dominant polycystic kidney disease (ADPKD) does not stray from this trend. As this rare condition is marked by reductions in kidney function, it’s integral to be able to predict the rate of said decline. We may now have a better understanding of how to do just this, thanks to a poster presentation at the National Kidney Foundation 2022 Spring Clinical Meetings back in April.
About the Study
The goal of this study was to evaluate predictors of outcomes in patients with ADPKD. To accomplish this, the researchers utilized longitudinal data sourced from real-life clinical practices. They used it to find affected individuals who are facing rapidly declining kidney function and then discern which factors could help predict said decline. To be more specific, 1,744 ADPKD patients were tested with latent class mixed models in order to identify those with estimated glomerular filtration rate (eGFR) trajectory that were declining quickly.
7%, or 125, of patients were discovered to meet the criteria for rapidly declining kidney function. The researchers went on to take 42 measurements to establish a baseline. After analysis, seven of the markers measured were found to be possible predictors: liver disease, serum creatinine, baseline age, hypertension, hemoglobin, cerebrovascular disease, and proteinuria. Following a balancing that utilized area under curve (AUC) and clinical implications, both age and liver disease were cut from the list, while sex was added. More specific results include:
- 70% accuracy
- 70% specificity
- 72% sensitivity
- 0.77 AUC
- Within the rapid decline group, there was an end-stage kidney disease (ESKD) rate of 38%
- This can be compared to a rate of 7% within the non-rapid decline group
Now, researchers can utilize these markers to better assess and care for their patients with ADPKD.
ADPKD is the most common form of polycystic kidney disease, and it is caused by a mutation in either the PKD1 or PKD2 gene. As the name suggests, these mutations are inherited from parents in an autosomal dominant pattern. They cause cysts to form on the kidneys and cause damage and functional decline. Symptoms include kidney stones, headaches, high blood pressure, cysts in the liver, hematuria, urinary tract infections, increased size of the abdomen, abnormal heart valves, cysts in the pancreas, brain aneurysm, kidney failure, pain in the back and sides, and pain between the ribs and hips. Unfortunately, there is no cure for this disorder, and treatment is symptomatic. This may include pain medications, dialysis, kidney transplants, surgical procedures, and more.
Find the source article from the Nephrology Times.