Factors relating to urinary protein excretion in children with autosomal dominant polycystic kidney disease.

Abstract

Adults with autosomal dominant polycystic kidney disease (ADPKD) who have overt proteinuria (>300 mg/d) have higher mean arterial pressures, lower creatinine clearances, larger renal volumes, and a more aggressive course of renal disease than ADPKD patients without proteinuria. This study examines the relationship between proteinuria and microalbuminuria and similar factors in ADPKD children. A total of 189 children from 81 ADPKD families was included in the analysis. The ADPKD children (n = 103) had significantly greater urine protein excretion rates than the non-ADPKD children (n = 86) (3.9+/-0.3 versus 2.8+/-0.2 mg/m2 per h, P < 0.001). Children with severe renal cystic disease (> 10 cysts; n = 54) had greater protein excretion than those with moderate disease (< or = 10 cysts; n = 49) (4.4+/-0.5 versus 3.3+/-0.2 mg/m2 per h, P < 0.05). The ADPKD children had significantly greater albumin excretion rates than the non-ADPKD children (32+/-6 versus 10+/-2 mg/m2 per 24 h, P < 0.001), and a higher percentage of ADPKD children had significant microalbuminuria (>15 mg/m2 per 24 h in boys and >23 mg/m2 per 24 h in girls) than their unaffected siblings (30% versus 10%, P < 0.05). Thirty percent of ADPKD children had albuminuria and 23% had overt proteinuria. For all ADPKD children, there was no correlation between proteinuria and hypertension. However, there was a significant correlation between urinary protein excretion and diastolic BP among children diagnosed after the first year of life (r = 0.23, P < 0.05). Therefore, proteinuria and albuminuria occur early in the course of ADPKD and may be markers of more severe renal disease.

• Authors: C Sharp, A Johnson, P Gabow
• Journal: Journal of the American Society of Nephrology : JASN (J Am Soc Nephrol) Vol. 9 Issue 10 Pg. 1908-14 (Oct 1998) ISSN: 1046-6673 [Print] United States
• PMID: 9773792 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Biomarkers

Topics

• Age Distribution
• Albuminuria (epidemiology, etiology)
• Biomarkers (urine)
• Child
• Child, Preschool
• Female
• Humans
• Incidence
• Male
• Polycystic Kidney, Autosomal Dominant (complications, urine)
• Prognosis
• Proteinuria (epidemiology, etiology)
• Reference Values
• Risk Factors
• Severity of Illness Index
• Sex Distribution