Clinical characteristics of patients with autosomal dominant polycystic kidney disease and risk factors for kidney function decline: a single-center study

Abstract Background Autosomal dominant polycystic kidney disease (ADPKD) leads to end-stage renal disease (ESRD) in approximately half of all patients with ADPKD by their sixth decade of life. Factors that cause kidney function decline in these patients are unclear. Methods This retrospective study included 124 adult patients with ADPKD who were followed up between January 2014 and December 2022. The primary outcome was kidney function decline, which was defined as a decline in the estimated glomerular filtration rate (eGFR) of at least 25% compared with that at baseline. A Cox proportional hazard analysis was performed to identify risk factors for kidney function decline. Results The median eGFR observation period was 30.0 months (12.0–48.0 months). Forty-eight patients experienced kidney function decline. The univariate Cox proportional hazards analysis indicated that duration ≥ 15 years between the diagnosis and referral to a nephrologist, baseline eGFR level < 57 mL/min/1.73 m 2 , baseline height-adjusted total kidney volume (htTKV) ≥ 800 mL/m, cyst infection, and proteinuria were associated with the risk of kidney function decline. Multivariate Cox proportional hazards analysis indicated that independent risk factors for kidney function decline were baseline htTKV ≥ 800 mL/m (hazard ratio [HR], 2.77; 95% confidence interval [CI], 1.28–5.97; P = 0.01), cyst infection (HR, 2.54; 95% CI, 1.02–6.34; P = 0.046), and proteinuria (HR, 2.23; 95% CI, 1.22–4.25; P = 0.01). Conclusions To prevent kidney function decline in patients with ADPKD, cyst growth, cyst infection, and proteinuria should be closely monitored.