Clinical Characteristics of Rapid Progression in Asia-Pacific Patients With ADPKD

Yun Kyu Oh; Hyunjin Ryu; Curie Ahn; Hayne C Park; Yiyi Ma; Dechao Xu; Tevfik Ecder; Tze-Wah Kao; Jeng-Wen Huang; Gopala K Rangan; RAPID-ADPKD Study Group

doi:10.1016/j.ekir.2023.06.018

Clinical Characteristics of Rapid Progression in Asia-Pacific Patients With ADPKD

Kidney Int Rep. 2023 Jun 26;8(9):1801-1810. doi: 10.1016/j.ekir.2023.06.018. eCollection 2023 Sep.

Authors

Yun Kyu Oh^{1

2}, Hyunjin Ryu², Curie Ahn², Hayne C Park³, Yiyi Ma⁴, Dechao Xu⁴, Tevfik Ecder⁵, Tze-Wah Kao⁶, Jeng-Wen Huang⁷, Gopala K Rangan⁸; RAPID-ADPKD Study Group

Collaborators

RAPID-ADPKD Study Group:
Yun Kyu Oh, Hyunjin Ryu, Curie Ahn, Hayne C Park, Yiyi Ma, Dechao Xu, Changlin Mei, Tevfik Ecder, Angela Yee-Moon Wang, Tze-Wah Kao, Jeng-Wen Huang, Gopala K Rangan

Affiliations

¹ Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
² Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
³ Department of Internal Medicine, Kangnam Sacred Heart Hospital, Seoul, Korea.
⁴ Department of Nephrology, Kidney Institute, Second Affiliated Hospital, Navy Medical University, Shanghai, China.
⁵ Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, Istanbul Bilim University, Istanbul, Turkey.
⁶ Division of Nephrology, Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.
⁷ Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
⁸ Michael Stern Laboratory for Polycystic Kidney Disease, Westmead Institute for Medical Research, The University of Sydney and the Department of Renal Medicine, Westmead Hospital, Western Sydney Local Health District, Westmead, New South Wales, Australia.

Abstract

Introduction: This study aimed to determine the utility of different methods to predict rapid progressors (RPs) and their clinical characteristics in Asia-Pacific patients with autosomal dominant polycystic kidney disease (ADPKD).

Methods: This was a multinational retrospective observational cohort study of patients with ADPKD in the Asia-Pacific region. Five hospitals from Australia, China, South Korea, Taiwan, and Turkey participated in this study. RP was defined by European Renal Association-European Dialysis and Transplantation Association (ERA-EDTA) guidelines and compared to slow progressors (SPs).

Results: Among 768 patients, 426 patients were RPs. Three hundred six patients met only 1 criterion and 120 patients satisfied multiple criteria for RP. Historical estimated glomerular filtration rate (eGFR) decline fulfilled the criteria for RP in 210 patients. Five patients met the criteria for a historical increase in height-adjusted total kidney volume (TKV). The 210 patients satisfied the criteria for based on kidney volume. During the follow-up period, cyst infections, cyst hemorrhage, and proteinuria occurred more frequently in RP; and 13.9% and 2.1% of RPs and SPs, respectively, progressed to end-stage kidney disease (ESKD). RP criteria based on historical eGFR decline had the strongest correlation with eGFR change over a 2-year follow-up.

Conclusion: Various assessment strategies should be used for identifying RPs among Asian-Pacific patients with ADPKD in real-world clinical practice during the follow-up period, cyst infections, cyst hemorrhage, and proteinuria occurred more frequently; and more patients progressed to ESKD in RPs compared with SPs.

Keywords: Asia-Pacific region; autosomal dominant polycystic kidney disease; estimated glomerular filtration rate; height-adjusted total kidney volume; rapid progression.