Autosomal dominant polycystic kidney disease in young adults
Víctor Martínez, Mónica Furlano, Laia Sans, Lissett Pulido, Rebeca García-Agudo, María Vanessa Pérez-Gómez, Jinny Sánchez-Rodríguez, Miquel Blasco, Cristina Castro-Alonso, Gema Fernández‐Fresnedo, Nicolás Roberto Robles, María Pau Valenzuela, Javier Naranjo, Nàdia Martín, Melissa Pilco Teran, Irene Agraz, Juan David González-Rodríguez, Nayara Panizo, Gloria Fraga, Loreto Fernández, María Teresa López, Cecilia Dall’Anese, Alberto Ortíz, Roser Torrá, participants in the REPQRAD, Luís Marcas, A Ríus, Patricia Tomás, Leonor García, Enrique Luna, María Adoración Martín, Pablo Íñigo, Judith Martins, Fernanda Ramos‐Delgado, Rosa Garcı́a, Laura García, María del Carmen Merino, María José Fernández‐Reyes, Leire Madariaga, Cristina Canal, Ana María Martínez, Rocío Echarri, Hanane Bouarich, Antonio Cabezas
Abstract
ABSTRACT Background The clinical manifestations of autosomal dominant polycystic kidney disease (ADPKD) usually appear in adulthood, however pediatric series report a high morbidity. The objective of the study was to analyze the clinical characteristics of ADPKD in young adults. Methods Family history, hypertension, albuminuria, estimated glomerular filtration rate (eGFR) and imaging tests were examined in 346 young adults (18–30 years old) out of 2521 patients in the Spanish ADPKD registry (REPQRAD). A literature review searched for reports on hypertension in series with more than 50 young (age <30 years) ADPKD patients. Results The mean age of this young adult cohort was 25.24 (SD 3.72) years. The mean age at diagnosis of hypertension was 21.15 (SD 4.62) years, while in the overall REPQRAD population was aged 37.6 years. The prevalence of hypertension was 28.03% and increased with age (18–24 years, 16.8%; 25–30 years, 36.8%). Although prevalence was lower in women than in men, the age at onset of hypertension (21 years) was similar in both sexes. Mean eGFR was 108 (SD 21) mL/min/1.73 m2, 38.0% had liver cysts and 3.45% of those studied had intracranial aneurysms. In multivariate analyses, hematuria episodes and kidney length were independent predictors of hypertension (area under the curve 0.75). The prevalence of hypertension in 22 pediatric cohorts was 20%–40%, but no literature reports on hypertension in young ADPKD adults were found. Conclusions Young adults present non-negligible ADPKD-related morbidity. This supports the need for a thorough assessment of young adults at risk of ADPKD that allows early diagnosis and treatment of hypertension.