Acute Kidney Injury in ADPKD Patients with Pneumonia

Abstract EN

Background.

In animal models, polycystic kidneys are susceptible to acute kidney injury (AKI).

We examined the occurrence of AKI in a cohort of autosomal dominant polycystic kidney disease (ADPKD) and non-ADPKD patients with acute pneumonia.

Design.

All ADPKD patients admitted to Mayo Clinic Rochester for pneumonia from January 1990 to April 2010 were examined.

Sixty-three patients had lobar infiltration and consolidation on chest X-ray.

After excluding patients on dialysis, with organ transplantation, and on chronic immunosuppression, 24 remaining ADPKD patients were enrolled.

Twenty-three of the 24 were matched with 92 (1 : 4 ratio) non-ADPKD pneumonia patients based on their baseline eGFR.

AKI was defined as serum creatinine elevation ≥0.3 mg/dL.

Results.

Sixteen of the 23 ADPKD patients (69.6%) and 36 of the 92 (39.1%) non-ADPKD patients developed AKI, P=0.008.

In both groups, those who developed AKI had a lower baseline eGFR (41.1±5.00 versus 58.7±11.8 in ADPKD and 40.2±3.65 versus 51.8±2.24 mL/min/1.73 m2 in the non-ADPKD group), more intensive care unit admissions, and longer hospital stays.

AKI was associated with a reduced survival in both groups.

Conclusions.

Patients with ADPKD admitted for acute pneumonia had more frequent episodes of AKI than non-ADPKD patients with comparable kidney function.