Kidney volume and functional outcomes in autosomal dominant polycystic kidney disease

Clin J Am Soc Nephrol. 2012 Mar;7(3):479-86. doi: 10.2215/CJN.09500911. Epub 2012 Feb 16.


Background and objectives: Autosomal dominant polycystic kidney disease (ADPKD) is characterized by increased total kidney volume (TKV) and renal failure. This study aimed to determine if height-adjusted TKV (htTKV) predicts the onset of renal insufficiency.

Design, setting, participants, & measurements: This prospective, observational, longitudinal, multicenter study included 241 adults with ADPKD and preserved renal function. Magnetic resonance imaging and iothalamate clearance were used to measure htTKV and GFR, respectively. The association between baseline htTKV and the attainment of stage 3 CKD (GFR <60 ml/min per 1.73 m(2)) during follow-up was determined.

Results: After a mean follow-up of 7.9 years, stage 3 CKD was attained in 30.7% of the enrollees. Using baseline htTKV, negative correlations with GFR increased from -0.22 at baseline to -0.65 at year 8. In multivariable analysis, a baseline htTKV increase of 100 cc/m significantly predicted the development of CKD within 8 years with an odds ratio of 1.48 (95% confidence interval: 1.29, 1.70). In receiver operator characteristic curve analysis, baseline htTKV of 600 cc/m most accurately defined the risk of developing stage 3 CKD within 8 years with an area under the curve of 0.84 (95% confidence interval: 0.79, 0.90). htTKV was a better predictor than baseline age, serum creatinine, BUN, urinary albumin, or monocyte chemotactic protein-1 excretion (P<0.05).

Conclusions: Baseline htTKV ≥600 cc/m predicted the risk of developing renal insufficiency in ADPKD patients at high risk for renal disease progression within 8 years of follow-up, qualifying htTKV as a prognostic biomarker in ADPKD.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Disease Progression
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Iothalamic Acid
  • Kidney / pathology*
  • Kidney / physiopathology*
  • Logistic Models
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Male
  • Multivariate Analysis
  • Odds Ratio
  • Organ Size
  • Polycystic Kidney, Autosomal Dominant / complications*
  • Polycystic Kidney, Autosomal Dominant / pathology
  • Polycystic Kidney, Autosomal Dominant / physiopathology
  • Prospective Studies
  • Renal Insufficiency / etiology*
  • Renal Insufficiency / pathology
  • Renal Insufficiency / physiopathology
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Time Factors
  • United States
  • Young Adult


  • Iothalamic Acid