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Saudi Journal of Kidney Diseases and Transplantation
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Table of Contents   
LETTER TO THE EDITOR  
Year : 2011  |  Volume : 22  |  Issue : 5  |  Page : 1044-1045
The prevalence of hypertension and nephrolithiasis in a sample of Iraqi patients with autosomal-dominant polycystic kidney disease


Al-Kindi College of Medicine, Faculty of Medicine, Baghdad, Iraq

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Date of Web Publication6-Sep-2011
 

How to cite this article:
Alsaedi AJ, Jamal H, Al-Windawi S. The prevalence of hypertension and nephrolithiasis in a sample of Iraqi patients with autosomal-dominant polycystic kidney disease. Saudi J Kidney Dis Transpl 2011;22:1044-5

How to cite this URL:
Alsaedi AJ, Jamal H, Al-Windawi S. The prevalence of hypertension and nephrolithiasis in a sample of Iraqi patients with autosomal-dominant polycystic kidney disease. Saudi J Kidney Dis Transpl [serial online] 2011 [cited 2022 Jan 28];22:1044-5. Available from: https://www.sjkdt.org/text.asp?2011/22/5/1044/84566
To the Editor,

ADPKD has highly variable manifestations, even within families, and can develop at any age (including infancy) and can have non-renal manifestations. [1]

To determine the prevalence of renal manifestations and the frequency of clinical presenting features in Iraqi ADPKD patients, we reviewed the cases of ADPKD followed-up in our nephrology clinic from September 2009 to January 2010. These cases were diagnosed with ADPKD according to ultrasonographic diagnostic criteria. We analyzed those cases with respect to age at presentation, sex, clinical features, family history, blood pressure measurement at the time of diagnosis, history of or concurrent nephrolithiasis and state of ESRD (the need for RRT) at the time of diagnoses. There were 30 cases (20 males and 10 females with a mean age of 32.13 years (34.85 years for males and 26.7 years for females). A positive family history was present in 29 cases (97%). The frequency of clinical presenting features was higher in males than in females with non-specific presentation (P = 0.03), including the frequency of nephrolithiasis (4 (13%) patients vs. 0, respectively, P = 0.007). Hypertension at the time of diagnosis was found in 11 patients (7 males with frequency of 68% vs. 4 females with frequency of 32%). ESRD was not found in any case at the time of diagnosis.

The study showed a higher prevalence (67%) of the condition among men, in contrast to a Brazilian study [2] that showed a higher prevalence (63%) among women. Another study reported a 65.5% prevalence of ADPKD in American women, [3] and a Saudi study [4] reported a prevalence of 57% among women. In our study, the mean age at diagnosis was 32.1 years; in the Saudi study, [4] this was 45 + 10.1, and in the Brazilian study [2] it was 35.1 ± 14.9 years. Pain was reported as the most frequent symptom in American patients, [5] while loin pain was the first presenting symptom in only 13% of the patients in our study. Gross hematuria was the initial event and lead to urgent medical consultation and rapid diagnosis in eight cases (26%) (75% males, 25% females) in our study, while it was less frequent in the Saudi study, [4] and was seen in 20% only, and was not included as the first presenting feature in the Brazilian study. [2] Urinary tract infections was recorded in 13% of our cases (50% males, 50% females), and abdominal mass was recorded in two cases (6.6%) (50% male, 50% females) in comparison with 33% and 44%, respectively, in the Brazilian study, [2] with a higher frequency in women. Positive family history was obtained in 29 of our cases (97%) in comparison with 57% and 57% in the Brazilian and Saudi studies, respectively. Our study showed a lower prevalence of nephrolithiasis (four (13.3%) cases, 100% males) than the Saudi study (16.7%), but comparable with the estimated prevalence reported in a sample of the American population [Figure 1]. [6] These low results in our study may be related to an inability to diagnose all cases with nephrolithiasis by ultrasonographic examination only, as computed tomography is the most sensitive imaging technique for the detection of stones, [7] which was used in all other studies but not in ours.
Figure 1: Prevalence of nephrolithiasis in patients with ADPKD in our study in comparison with other studies.

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Arterial hypertension was found in 36.6% of our patients at the time of diagnosis, which is a much lower finding than that found in the Brazilian (63.3%) and the Saudi (57%) studies [Figure 2]. The prevalence of arterial hyperten sion in American patients with ADPKD reported in other studies [8] was approximately 60%, even with normal renal function.
Figure 2: Prevalence of hypertension in patients with ADPKD in our study in comparison with other studies.

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   References Top

1.Goldman L, Ausiello DA. Cecil Medicine, 23 rd Edition. Chapter 128, section 11, Cystic kidney disease. 2006;903-6.  Back to cited text no. 1
    
2.Romao EA, Moyses Neto M, Teixeira SR, et al. Renal and extra renal manifestations of autosomal dominant polycystic kidney disease. Braz J Med Biol Res 2006;39:533-8.  Back to cited text no. 2
    
3.Schrier RW, McFann KK, Johnson AM. Epidemiological study of kidney survival in autosomal dominant polycystic kidney disease. Kidney Int 2003;63:678-85.  Back to cited text no. 3
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4.Al-Muhanna FA, Malhotra KK, Saeed I, Al-Mueilo S. Autosomal dominant polycystic kidney disease: Observations from a university hospital in Saudi Arabia. Saudi J Kidney Dis Transpl 1995;6:28.  Back to cited text no. 4
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5.Bajwa ZH, Sial KA, Malik AB et al. Pain patterns in patients with polycystic kidney disease. Kidney Int 2004;66:1561-9.  Back to cited text no. 5
    
6.Soucie JM, Thun MJ, Coates RJ, et al. Demographic and geographic variability of kidney stones in the United States. Kidney Int 1994; 46:893-9.  Back to cited text no. 6
[PUBMED]    
7.Torres VE, Wilson MD, Httery RR, Segura JW. Renal stone disease in autosomal dominant polycystic kidney disease. Am J Kidney Dis 1993;22(4):513-9.  Back to cited text no. 7
    
8.Ecder T, Schrier RW. Hypertension in autosomal-dominant polycystic kidney disease: early occurrence and unique aspects. J Am Soc Nephrol 2001;12:194-200.  Back to cited text no. 8
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Correspondence Address:
Ali Jasim Alsaedi
Al-Kindi College of Medicine, Faculty of Medicine, Baghdad
Iraq
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PMID: 21912048

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