Assessing Average Proteinuria and Blood Pressure as Predictors of Kidney Survival in Autosomal Dominant Polycystic Kidney Disease

Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a common hereditary kidney disorder characterized by bilateral cyst formation and progressive kidney damage. Predicting prognosis at diagnosis and during follow-up can be challenging. Beyond genetics and total kidney volume, clinical features such as blood pressure profile and proteinuria may be valuable. We evaluated 116 ADPKD patients from medical records in terms of demographic and clinical parameters, as well as two new variables: average blood pressure (calculated as the mean across all visits) and average proteinuria (also calculated across all visits). Univariate and multivariate analyses of these parameters were performed to assess their association with renal replacement therapy and other renal outcome measures. The study included 116 ADPKD patients with a median age of 44.5 years and a follow-up period of 55 months. Hypertension was common (76.7%), with most patients receiving RAS blockade therapy. A lower eGFR at presentation was a key predictor of worse renal outcomes. Diastolic blood pressure and RAS blockade were significantly associated with disease progression. However, multivariate analysis did not confirm proteinuria, smoking, or extrarenal manifestations as independent predictors of creatinine doubling or eGFR halving time. Efforts to predict prognosis in ADPKD using clinical features beyond genetics remain a subject of debate. Future studies with larger cohorts are needed to validate the role of these parameters in predicting ADPKD progression.