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Presence of ADPKD in patients with normal kidney function is associated with impaired beta cell function after an oral glucose load, without a significant decrease in insulin sensitivity.

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Background: The aim of this work was to compare the prevalence of the metabolic syndrome (MS) and its components between a group of autosomal-dominant polycystic kidney disease (ADPKD) patients with normal kidney function and no prior diagnosis of diabetes and healthy controls. Methods: Forty-nine patients with ADPKD (age 35.9 ± 11.1 years) with serum creatinine <1.35 mg/dl and 50 healthy controls (36.7 ± 9.2 years) were enrolled for the study. Physical examination, basic laboratory measurements and oral glucose tolerance test were performed in all subjects. Results: In the group of ADPKD patients, when compared to controls, the following values were significantly higher: waist-to-hip ratio (0.84 ± 0.09 vs. 0.81 ± 0.10, p = 0.046), systolic blood pressure (133.9 ± 19.8 vs. 122.2 ± 14.9 mm Hg, p = 0.0023), diastolic blood pressure (92.9 ± 12.4 vs. 82.9 ± 9.3 mm Hg, p < 0.0001), fasting glycemia (91.6 ± 10.5 vs. 84.5 ± 9.2 mg/dl, p = 0.04), and HbA_1C (5.41 ± 0.35 vs. 5.28 ± 0.33%, p = 0.06, borderline significance). Adult Treatment Panel III criteria of MS were fulfilled by 14% of patients and 14% of controls, while International Diabetes Federation criteria were fulfilled by 22% of patients and 20% of controls, without any significant difference between the groups. Conclusion: The presence of ADPKD with normal kidney function is associated with components of MS such as hypertension, abdominal obesity and higher fasting glycemia.

Background: The aim of this study was to compare echocardiographic parameters in patients with autosomal dominant polycystic kidney disease (ADPKD) and in controls with normal kidney function taking into account gender and the presence of hypertension. Methods: 47 patients with ADPKD (age 36.3 ± 11.0 years) and 49 healthy controls (36.8 ± 9.2 years) were enrolled. M-mode echocardiography was performed in all subjects. Left ventricular hypertrophy (LVH) was diagnosed when the left ventricular mass index (LVMI) was greater than or equal to 125 g/m² in males and 110 g/m² in females. Results: The prevalence of LVH was greater in ADPKD patients than in controls (13% vs 2%; p=0.05). Among females, ADPKD patients demonstrated greater LVMI (87.9 ± 18.5 vs 68.8 ± 15 g/m², p=0.00009) than controls. There was a positive correlation between LVMI and blood pressure in ADPKD females (Rs=0.54, p=0.027 for systole blood pressure-SBP and Rs=0.50, p=0.0053 for diastole blood pressure-DBP) but not in males. Conclusion: Left ventricular mass is increased in ADPKD females with normal renal function. A positive correlation between SBP and DBP and LVMI was found in ADPKD females but not in ADPKD males.

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IntroductionThe aim of this study was to assess calcium-phosphate metabolism of autosomal dominant polycystic kidney disease (ADPKD) patients with a special consideration to the following serum parameters: calcium (Ca2+), inorganic phosphate (Pi), parathyroid hormone (PTH) and intracellular erythrocyte calcium ([Ca2+]i) concentrations.Material and methodsThe study included 49 adult ADPKD patients (19 males, 30 females) aged 36 ±11 years with normal renal function and no diagnosis of diabetes as well as 50 healthy controls (22 males, 28 females) matched for age and gender. Serum concentrations of sodium (Na+), potassium (K+) and magnesium (Mg2+) ions and Pi were determined with an indirect ion-selective method, while Ca2+ concentration was measured with a direct ion-selective method. The PTH was detected using a radioimmunometric method. [Ca2+]i concentration was determined with the Ca2+ sensitive fluorescent dye Fura-2 method.ResultsIn the ADPKD group, when compared to controls, the following concentrations were significantly higher: serum Ca2+ (1.18 ±0.06 mmol/l vs. 1.15 ±0.06 mmol/l, p = 0.0085), [Ca2+]i (146.9 ±110.0 nmol/l vs. 96.5 ±52.7 nmol/l, p = 0.0075), serum Na+ (139.4 ±2.7 mmol/l vs. 138.5 ±2.1 mmol/l, p = 0.060, borderline significance), and PTH (15.5 ±6.8 pg/ml vs. 13.6 ±5.3 pg/ml, p = 0.066, borderline significance), while serum Mg2+ was significantly lower (0.81 ±0.09 mmol/l vs. 0.85 ±0.05 mmol/l, p = 0.021). In the ADPKD group we observed significant negative correlations of PTH with Ca2+ serum concentrations (Rs = –0.32, p = 0.025) and with estimated glomerular filtration rate (Rs = –0.31, p = 0.033).ConclusionsThe erythrocyte Ca2+ concentration is elevated in ADPKD patients with normal renal function. It may result from a dysfunction of mutated polycystins which can affect various aspects of electrolyte metabolism.

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