Hypertension in young adults with autosomal dominant polycystic kidney disease: a case for early screening?

Abstract

ADPKD is the most common hereditary kidney disease and a major cause of kidney failure world-wide. Significant kidney enlargement occurs decades preceding loss of kidney function. However, the earliest clinical manifestations of disease have been less well characterized in young adults, a typically healthy population who do not often seek routine medical care. In this study, Martinez and colleagues report a high prevalence of hypertension among young adults (18-30 years) enrolled in the Spanish ADPKD registry REPQRAD. Their findings confirm previous studies in children and young adults with ADPKD and make a strong case for earlier screening and intervention within this age group.

Keywords: ADPKD; age; ambulatory blood pressure monitoring; cardiovascular; hypertension.

Figure 1:

The relationship between hypertension, TKV and kidney function decline in children and young adults with ADPKD. (A) A more rapid increase in TKV measured by ultrasound (US) with age occurs in individuals with hypertension as compared to those with normal blood pressure. (B) Hypertensive young individuals show significantly greater decline in annualized eGFR over 5 years’ follow up, as assessed by 24-hour urine creatinine clearance (CrCl), compared to those with normal blood pressure (HTN, hypertension, shown in blue. NBP, normal blood pressure, shown in orange). Figure adapted from [2].