The correlation between hypertension and renal function, left venticular hypertrophy and renal structure in autosomal dominant polycystic kidney disease

Hippokratia 2002, 6(4):193-197

A Idrizi, M. Barbullushi, S Qirko, A Koroshi, E Petrela


The aim of this study was to evaluate the frequency of hypertension in autosomal dominant polycystic kidney disease (ADPKD) patients and its correlation with renal function, renal structure and its influence in left ventricular wall.Two hundred patients were included in the study. The patients were divided in two groups: first group of 92 patients with normal renal function, and second group of 108 patients with chronic renal failure. All patients performed an abdominal ultrasound and a M-mode echocardiography.Hypertension was observed in 140 ADPKD patients (70%): 56 of first group (61%) and 84 of second group (79%). Subjects who developed hypertension before age 35 had worse renal survival than those who remained normotensive after age 35 (50 years vs. 62 years; ρ < 0.0001; risk ratio = 4.3). Hypertensive patients had significantly higher serum creatinine concentration than those without hypertension (p < 0.001). Left ventricular hypertrophy was present in 56 patients with hypertension (40%) and in 9 normotensive patients (16%) (p < 0.005). Patients with LVH had a worse renal survival than those without LVH (p < 0.001). Also, we have studied the role of renal cystic enlargement in initiating hypertension in ADPKD and on renal function. We conclude that hypertension is a common complication in our ADPKD patients, considering as an important factor of cardiac hypertrophy. LVH could be considered a more valid measure of blood pressure control than office blood pressure measurements. The blood pressure correlates with kidney size in ADPKD patients. More increased kidney volume, highest blood pressure is observed. These findings suggest that hypertension is a serious complication in ADPKD that may lead to both an increased incidence of cardiovascular complications and more rapid progression of renal functional impairment.