#6156 TUBULAR CHANGES IN PATIENTS WITH AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE

Abstract

Abstract Background and Aims Autosomal dominant polycystic kidney disease (ADPKD) is characterized by the presence of multiple cysts, leading to progressive reduction in renal function and systemic involvement. The possible presence of tubular alterations has been suggested, but the mechanisms involved have not yet been fully identified. The study aims to highlight possible tubular alterations in ADPKD patients compared to patients with chronic kidney disease (CKD). Method A total of 145 patients were enrolled, including 37 with ADPKD and CKD, while 108 had CKD with the same clinical characteristics, and a comparative analysis of urinary and serum parameters were performed. A venous blood gas analysis was performed on each patient to assess serum pH, lactate concentration, and base excess, and a spot urine test was performed to evaluate urinary pH using a pH meter and specific gravity (SG). Results The comparative analysis of serum parameters showed a significant reduction in serum pH (spH) in ADPKD patients (p <0.001), with a significant increase in lactates (1.3 vs 0.9 mmol/L, p <0.001) and a significant reduction in base excess (BE) (p <0.001). The evaluation of urinary parameters in ADPKD patients showed a urinary pH (upH) that was on average more acidic compared to patients with CKD (p < 0.001) with a reduction in the capacity to concentrate urine (p < 0.001). No statistically significant differences were found in terms of glomerular filtration rate between the two groups. Conclusion The collected data showed some alterations in the serum and urinary metabolic profile of ADPKD patients compared to the CKD group. The alterations in upH are consistent with those of recent studies in the literature, where it is hypothesized that a urinary concentration defect, already present in early stages, may cause a reduction in upH due to a reduced medullary trapping of ammonium and a reduced presence of bicarbonates. The hypothesis of a preferentially anaerobic metabolism in ADPKD patients is also in line with the increased levels of serum lactates.