The Quironsalud Hospital in Málaga integrates a system to predict the progression towards end-stage renal failure in polycystic kidney disease; the most common hereditary kidney disease, affecting one in a thousand cases. Measuring kidney volume using magnetic resonance imaging is a very useful test to quickly and safely analyze and calculate the prognosis of autosomal dominant polycystic kidney disease (PKD), according to the study. doctor Francisco Amaral, head of the nephrology department at the Quirónsalud Hospital in Málaga and specialist at the Quirónsalud Hospital in Córdoba.
Dr. Amaral explained that autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disease, with a global prevalence of one case per thousand people, being one of the leading causes of end-stage renal failure worldwide. Recent studies establish that the prevalence is 61/100,000 inhabitants and it is even estimated that there are many unidentified cases, since it is considered that ““Only a quarter of patients with ADPKD are diagnosed.”.
It’s a autosomal dominant genetic disease, which means that half of children can inherit it: “each child of an affected parent has a 50% chance of suffering from the disease”. Furthermore, the majority of patients with this disease will have a family history of kidney failure or dialysis,” explains the nephrologist. Despite this, many patients will present mutations new and they will be the first in their family to present the disease, which is why – adds the doctor – early detection is very important to avoid its transmission to offspring, through genetic counseling.
The most characteristic clinical manifestation of polycystic kidney disease is formation of kidney cysts that throughout life increases in number and size, so that as the number of cysts increases, functional kidney mass decreases and loss of kidney function occurs, with “possible onset over time.” years of high blood pressure, lithiasis or renal failure, which is the most serious manifestation of the disease. So much so that “50% of patients with ADPKD require renal replacement therapy (dialysis or transplantation) at an average age of 57 years.”.
Not all mutations of this disease will have equal progression. There are therefore patients who progress to end-stage renal failure before the age of 40 and others who maintain normal renal function into advanced age. For this reason, It is important to determine the prognosis of the disease, as it is essential to be able to carry out early follow-up and avoid future complications. or get ahead of them as much as possible. Today, underlines the head of the nephrology department at Quirónsalud Málaga, ““The best way to predict this outcome or prognosis is to measure kidney volume using magnetic resonance imaging.”.
For his part, the Dr Carlos Alonso, head of the diagnostic imaging department at Quirónsalud Hospital in Málaga shared that the procedure to follow begins with “carrying out a MRI of the patient’s abdomen, which includes images in all three planes of space, including both kidneys in their entirety.. Magnetic resonance imaging is a safe test that does not use ionizing radiation and, moreover, in this case it is carried out without intravenous contrast, so the risks associated with its use disappear.
Once the images have been obtained, the radiologist calculates the volume of each kidney, using several methods at your disposal to then calculate the total renal volume (the sum of the volumes of each kidney). These data “are adjusted according to the size of each patient and we obtain a value which allows “predict kidney growth each year and the risk of kidney function deterioration”.
Finally, Dr. Francisco Amaral Neiva recalls that the Quirónsalud Hospital in Málaga has a nephrology team experienced in the study and monitoring of patients with this pathology, as well as in the study and treatment of other diseases that contribute to deterioration of kidney function such as hypertension, diabetes mellitus or high cholesterol. Furthermore, the addition of such techniques to the radiodiagnostic service allows the correct imaging diagnosis and prognosis of these patients.
All patient with family history of end-stage renal disease (advanced kidney failure, dialysis or transplantation) is likely to be the subject of a nephrology study to exclude kidney disease and also monitor the kidney health of the population.
