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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)

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Abstract

Background

Factors affecting decline in renal function and cyst growth in patients with autosomal polycystic kidney disease (ADPKD) are not fully described, particularly in Japan.

Methods

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.

Results

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).

Conclusions

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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Acknowledgements

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.

Author information

Authors and Affiliations

  1. Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan

    Kiyotaka Uchiyama

  2. Clinical Research Division for Polycystic Kidney Disease, Department of Nephrology, Tokyo Women’s Medical University, Tokyo, Japan

    Toshio Mochizuki, Hiroshi Kataoka & Michihiro Mitobe

  3. Department of Nephrology, Tokyo Women’s Medical University, Tokyo, Japan

    Toshio Mochizuki, Hiroshi Kataoka & Michihiro Mitobe

  4. Intelligent Systems Laboratory, SECOM CO., LTD., Mitaka, Tokyo, Japan

    Yosuke Shimada

  5. Department of Medical Electronic Intelligence Management, Juntendo University Graduate School, Bunkyo, Tokyo, Japan

    Yosuke Shimada

  6. Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan

    Saori Nishio

  7. Department of Blood Purification, Tokyo Woman’s Medical University, Tokyo, Japan

    Ken Tsuchiya

  8. Department of General Internal Medicine, Jikei University School of Medicine, Tokyo, Japan

    Kazushige Hanaoka

  9. Department of Nephrology, Toranomon Hospital, Tokyo, Japan

    Yoshifumi Ubara, Tatsuya Suwabe & Akinari Sekine

  10. Department of Urology, Kyorin University School of Medicine, Tokyo, Japan

    Kikuo Nutahara

  11. Department of Integrated Therapy for Chronic Kidney Disease, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Kazuhiko Tsuruya

  12. Department of Nephrology, Nara Medical University, Kashihara, Nara, Japan

    Kazuhiko Tsuruya

  13. Department of Nephrology, Osaka City University Graduate School of Medicine, Osaka, Japan

    Eiji Ishimura

  14. Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan

    Shinya Nakatani

  15. Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University, Kagawa, Japan

    Tadashi Sofue

  16. Department of Nephrology, Shizuoka General Hospital, Shizuoka, Japan

    Satoshi Tanaka

  17. Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medicine and Dental Science, Niigata, Japan

    Ichiei Narita

  18. Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Shoichi Maruyama

  19. Department of Advanced Informatics for Genetic Disease, Juntendo University, Tokyo, Japan

    Shigeo Horie & Satoru Muto

  20. Department of Urology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Shigeo Horie & Satoru Muto

Authors
  1. Kiyotaka Uchiyama
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  2. Toshio Mochizuki
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  3. Yosuke Shimada
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  4. Saori Nishio
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  5. Hiroshi Kataoka
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  6. Michihiro Mitobe
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  7. Ken Tsuchiya
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  8. Kazushige Hanaoka
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  9. Yoshifumi Ubara
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  10. Tatsuya Suwabe
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  11. Akinari Sekine
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  13. Kazuhiko Tsuruya
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  14. Eiji Ishimura
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  16. Tadashi Sofue
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  17. Satoshi Tanaka
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  18. Ichiei Narita
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  19. Shoichi Maruyama
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  20. Shigeo Horie
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  21. Satoru Muto
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Corresponding author

Correspondence to Satoru Muto.

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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..

Ethical approval

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).

Informed consent

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

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