Received December 23, 2005
Accepted on April 26, 2006
Computed Tomography Evaluation of Autosomal Dominant Polycystic Kidney Disease Progression: A Progress Report
Luca Antiga *,
Marina Piccinelli *,
Giorgio Fasolini 
,
Bogdan Ene-Iordache *,
Patrizia Ondei 
,
Simona Bruno 
,
Giuseppe Remuzzi 1,
and
Andrea Remuzzi *
*Biomedical Engineering Department and Kidney Disease Department, Mario Negri Institute for Pharmacological Research, and Radiology Unit and Nephrology and Dialysis Unit, Azienda Ospedaliera Ospedali Riuniti di Bergamo, Bergamo, Italy
1 To whom correspondence should be addressed. E-mail: aremuzzi{at}marionegri.it.
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Abstract |
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At the moment, there are no effective therapies to prevent or slow the progression of autosomal dominant polycystic kidney disease (ADPKD). Radiologic evaluations are used to monitor volume of renal cysts and parenchyma during disease evolution. Volumetric quantifications based on computed tomography were used to investigate the relation between structural and functional changes in patients with advanced-stage ADPKD. By use of image-processing techniques, volume of kidneys, renal cysts, fully enhanced parenchyma, and faintly contrast-enhanced parenchyma, referred to as intermediate, was estimated. GFR measurements and computed tomography evaluations were repeated 6 mo later. No statistically significant correlations were found between volumes of cysts and parenchyma and intermediate volume and GFR. However, the ratio of intermediate over parenchymal volume strongly correlated with GFR (r = -0.81, P < 0.001). In addition, there were significant correlations between percentage changes in intermediate volume (absolute or relative to parenchyma) and GFR changes during the observation period (r = -0.70 and r = -0.75, P < 0.01). These data support the hypothesis of a significant relation between radiologic appearance of renal structure and functional changes and suggest new ways that renal dysfunction in ADPKD may be predicted. Further work is necessary to determine the nature of faintly contrast-enhanced parenchyma and its role in renal functional loss.
