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논문분류	춘계학술대회 초록집
제목	The Clinical Characteristics of Advanced Chronic Kidney Disease with Small Total Kidney Volume in Autosomal Dominant Polycystic Kidney Disease: A Subgroup Should Be Spotlighted
저자	Soo Whan Jung, Hyungjin Ryu, Hayne Park, Hyunsuk Kim, Yun Kyu Oh, Curie Ahn
출판정보	2019; 2019(1):
키워드	ADPKD \| Chronic kidney disease \| hyperuricemia \| urine NAG/Cr \| htTKV
초록	In the defining the rapid progressor in autosomal dominant polycystic kidney disease (ADPKD), height adjusted total kidney volume (htKTV) is one of most important surrogate marker of disease progression. However there are subgroups of ADPKD patients with advanced chronic kidney disease (CKD) patients without significant increase in htTKV. In here, we conducted a study to find out the clinical characteristics of the population. This is a cross-sectional study, done in the outpatients from Seoul National University Hospital ADPKD clinic. Total 497 adult patients were enrolled and demographic information, medical history, laboratory results, PKD gene genotypes and ellipsoid htTKV value from CT or MRI images were collected. The patients were classified into four subgroups based on htTKV (800mL/m) and CKD stages as follow: Subgroup A as CKD stage G3-G5 and htTKV<800mL/m, subgroup B as CKD stage G1 and 2 and htTKV<800mL/m, subgroup C as CKD stage G1&2 and htTKV<800mL/m and subgroup D as CKD stage G3-5 and htTKV≥800mL/m. Mean age was 48.9±11.5 years and 51.5% were female. Mean eGFR was 71.5±26.5 ml/min/1.73m2 and the median htTKV were 800mL/m [IQR 472;1291]. In the study population, 6.4%, 43.5% and 26.2% were classified in to subgroup A, B and C respectively. (Figure) The patients in subgroup A were older, had higher uric acid level and more patients were taking uric acid lowering agents. The level of urine N-acetyl-β-D glucosaminidase/Creatinine(NAG/Cr) was significantly higher in subgroup A compared to B, even after age was adjusted. There were no significant differences in the genotypes, rate of blood pressure control, dyslipidemia, and history of acute kidney injury, acute pyelonephritis or urinary tract stone between subgroup A and B (Table). High serum uric acid and urine NAG/Cr level were significant characteristics of ADPKD subgroup with advanced CKD stages and small htTKV compared to early CKD patients with small htTKV.
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