Proteinuria and Hypertension in Autosomal Dominant Polycystic Kidney Disease

Ana Gonzalo, MD, Servicio de Nefrologia, Hospital Ramon y Cajal, Crta. Colmenar Km 9,100, E-28034 Madrid (Spain) Dear Sir, The prevalence of proteinuria in primary established hypertension was found to be between 10 and 20%. In autosomal dominant polycystic kidney disease (ADPKD) mild to moderate proteinuria has been observed in patients with advanced renal failure [1-3] or more infrequently as a consequence of superimposed glomerular disease. We studied retrospectively 31 young and middle-aged ADPKD patients (13 normo-tensive and 18 hypertensive) with normal renal function. The mean age was 32 years (range from 19 to 45 years). All hypertensive patients underwent treatment with angioten-sin-converting enzyme inhibitors. Before renal function deteriorated, 5 of the 18 treated hypertensive patients developed overt proteinuria (greater than 4 mg/kg/day), whereas it did not appear in the normotensive ones. The average proteinuria was 9.3 mg/kg/day (range from 5 to 12 mg/kg/day). Comparisons between arterial pressure values in the proteinuric and nonproteinuric groups were performed using a nonparametric test (the Wilcoxon two-sample test, i.e. U test), at 1 year and 2 years of follow-up. It was not possible to perform this test for basal data because there was only 1 case with proteinuria. However, this patient exhibited the highest Table 1. Average arterial pressure in proteinuric and nonproteinuric treated hypertensive ADPKD patients during follow-up Basal 1 year 2 years