[The relation of hypertension, renal function and cardiovascular events in autosomal dominant polycystic kidney disease].

Background: The presence of hypertension in autosomal dominant polycystic kidney disease (ADPKD) appear to be related with progressive renal failure and end-organ damage, including left ventricular hypertrophy (LVH) in these patients. The aim of this study was to evaluate the frequency of hypertension in ADPKD patients and its correlation with renal function, renal structure and its influence in left ventricular wall.

Methods: 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.

Results: Hypertension was observed in 140 ADPKD patients (70%). Subjects who developed hypertension before age 35 had worse renal survival than those who remained normotensive after age 35 (50 years vs. 62 years; p<0.0001; risk ratio = 4.3). Hypertensive patients had significantly higher serum creatinine concentration than those without hypertension (p<0.001). LVH 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).

Conclusions: 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.