Kidney Week

Abstract: TH-PO468

Long-Term Trajectories of Kidney Function in ADPKD: Follow-Up of CRISP and HALT-PKD-Study A Cohorts

Session Information

• Cystic Kidney Diseases: Clinical Assessment and Therapeutic Directions
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Genetic Diseases of the Kidneys

• 1201 Genetic Diseases of the Kidneys: Cystic

Authors

• Rahbari-Oskoui, Frederic F., Emory University, Atlanta, Georgia, United States

Frederic F. Rahbari-Oskoui, MD, MS, FASN

• Parker, Chelsie, Indiana University, Bloomington, Indiana, United States

Chelsie Parker, MS

• Landsittel, Doug, University at Buffalo, Buffalo, New York, United States

Doug Landsittel, PhD

• Ables, Erin, Indiana University, Bloomington, Indiana, United States

Erin Ables, MA

• Golzarri-Arroyo, Lilian, Indiana University, Bloomington, Indiana, United States

Lilian Golzarri-Arroyo, MSc

• Harris, Peter C., Mayo Clinic Minnesota, Rochester, Minnesota, United States

Peter C. Harris, PhD

• Chapman, Arlene B., University of Chicago Pritzker School of Medicine, Chicago, Illinois, United States

Arlene B. Chapman, MD

• Torres, Vicente E., Mayo Clinic Minnesota, Rochester, Minnesota, United States

Vicente E. Torres, MD, PhD

• Mrug, Michal, The University of Alabama at Birmingham, Birmingham, Alabama, United States

Michal Mrug, MD

• Chebib, Fouad T., Mayo Clinic in Florida, Jacksonville, Florida, United States

Fouad T. Chebib, MD, FASN

• Bae, Kyongtae Ty, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong

Kyongtae Ty Bae, MD, PhD

• Bennett, William M., Legacy Health System, Portland, Oregon, United States

William M. Bennett, MD, FASN

• Yu, Alan S.L., The University of Kansas Medical Center, Kansas City, Kansas, United States

Alan S.L. Yu, MBChB

Group or Team Name

• Consortium for Radiologic Imaging Studies of Polycystsic kidney disease (CRISP) and The HALT-PKD Trial.

Background

Previously, we reported trajectories of estimated Glomerular filtration rate (eGFR) decline in 241 patients in the CRISP study. However, those reports were limited by the relatively small sample size and lack of external validation in other PKD cohorts.
This study aimed to develop long term trajectories in a large PKD cohort that included the observational CRISP study and the HALT-PKD-Study A hypertension trial.

Methods

721 patients (age 15-49 with baseline eGFR >60 mL/min/1.73 m²) were included and followed for up to 21.2 years. Routine laboratory and detailed genetic results, and Mayo imaging class (MIC) were used in linear mixed models (including a term for age² and interactions with age) by forcing in essential variables and using a forward selection process to select other clinical biomarkers. Polynomial graphics and slopes of eGFR were calculated for each MIC per decade of life. Goodness of fit was assessed by calculating mean differences between observed and predicted eGFRs over 10-year age intervals.

Results

The best gender-specific polynomial trajectory models were developed by including age, sex, serum creatinine, ADPKD genotype mutation strength group, MIC, serum CO₂ and uric acid, and hemoglobin levels, diastolic blood pressure (DBP), race, presence of hypertension, and body mass index. The slopes of decline of eGFR vary widely from -0.39 to -5.89 (from slow to fast progressors) and continuously accelerated in time within each MIC.

Conclusion

We developed more robust, gender-specific, long-term trajectories of eGFR for each MIC category over 21.2 years of follow up, in a well-characterized ADPKD cohort. Serum CO₂, uric acid, hemoglobin, race, presence of hypertension, BMI and DBP were identified as additional parameters of relevance. External validation of these models is underway, on the Mayo PKD registry.

Funding

• NIDDK Support