Journal Article

Analysis of baseline parameters in the HALT polycystic kidney disease trials

Torres, Vicente E., Steinman, Theodore I., Masoumi, Amirali, Halin, Neil J., Miller, J Philip, Perrone, Ronald D., Thompson, Paul A., Schrier, Robert W., Wetzel, Louis H., Hogan, Marie C., Winklhofer, Franz T., Oskoui, Frederic R., Glockner, James, Chapman, Arlene B., Miskulin, Dana C., Abebe, Kaleab Z., Kelleher, Cass, Martin, Diego R., Braun, William E., Remer, Erick, Patel, Nayana, Pedrosa, Ivan, Bost, James E., Meyers, Catherine M., Ty Bae, K.

2012

Overview

HALT PKD consists of two ongoing randomized trials with the largest cohort of systematically studied patients with autosomal dominant polycystic kidney disease to date. Study A will compare combined treatment with an angiotensin-converting inhibitor and receptor blocker to inhibitor alone and standard compared with low blood pressure targets in 558 early-stage disease patients with an eGFR over 60ml/min per 1.73m2. Study B will compare inhibitor-blocker treatment to the inhibitor alone in 486 late-stage patients with eGFR 25–60ml/min per 1.73m2. We used correlation and multiple regression cross-sectional analyses to determine associations of baseline parameters with total kidney, liver, or liver cyst volumes measured by MRI in Study A and eGFR in both studies. Lower eGFR and higher natural log-transformed urine albumin excretion were independently associated with a larger natural log–transformed total kidney volume adjusted for height (ln(HtTKV)). Higher body surface area was independently associated with a higher ln(HtTKV) and lower eGFR. Men had larger height-adjusted total kidney volume and smaller liver cyst volumes than women. A weak correlation was found between the ln(HtTKV) and natural log–transformed total liver volume adjusted for height or natural log liver cyst volume in women only. Women had higher urine aldosterone excretion and lower plasma potassium. Thus, our analysis (1) confirms a strong association between renal volume and functional parameters, (2) shows that gender and other factors differentially affect the development of polycystic disease in the kidney and liver, and (3) suggests an association between anthropomorphic measures reflecting prenatal and/or postnatal growth and disease severity.

• Publisher: Elsevier Inc,Nature Publishing Group,Elsevier Limited
• Subject: ADPKD / Adult / Angiotensin II Type 1 Receptor Blockers - therapeutic use / Angiotensin-Converting Enzyme Inhibitors - therapeutic use / Antihypertensive Agents - therapeutic use / Biological and medical sciences / Blood Pressure - drug effects / Chi-Square Distribution / chronic renal disease / Cysts - genetics / Cysts - pathology / Disease Progression / Double-Blind Method / Drug Therapy, Combination / Female / Genetic Predisposition to Disease / Glomerular Filtration Rate - drug effects / Humans / Hypertension - drug therapy / Hypertension - genetics / Hypertension - pathology / Hypertension - physiopathology / Kidney - drug effects / Kidney - pathology / Kidney - physiopathology / Kidney Failure, Chronic - genetics / Kidney Failure, Chronic - pathology / Kidney Failure, Chronic - physiopathology / Kidney Failure, Chronic - prevention & control / kidney volume / Kidneys / Liver Diseases - genetics / Liver Diseases - pathology / Male / Malformations of the urinary system / Medical sciences / Middle Aged / Multivariate Analysis / Nephrology. Urinary tract diseases / Organ Size / polycystic kidney disease / Polycystic Kidney, Autosomal Dominant - drug therapy / Polycystic Kidney, Autosomal Dominant - genetics / Polycystic Kidney, Autosomal Dominant - pathology / Polycystic Kidney, Autosomal Dominant - physiopathology / Prospective Studies / Regression Analysis / renal function / Risk Assessment / Risk Factors / Treatment Outcome / Urinary system involvement in other diseases. Miscellaneous