Abstract
BackgroundCaffeine has been proposed, based on in vitro cultured cell studies, to accelerate progression of autosomal dominant polycystic kidney disease (ADPKD) by increasing kidney size. Since ADPKD patients are advised to minimize caffeine intake, we investigated the effect of caffeine on disease progression in the Consortium for Radiologic Imaging Studies of Polycystic Kidney Disease (CRISP), a prospective, observational cohort study.MethodsOur study included 239 patients (mean age = 32.3 ± 8.9 ys; 188 caffeine consumers) with a median follow-up time of 12.5 years. Caffeine intake reported at baseline was dichotomized (any vs. none). Linear mixed models, unadjusted and adjusted for age, race, sex, BMI, smoking, hypertension, genetics and time, were used to model height-adjusted total kidney volume (htTKV) and iothalamate clearance (mGFR). Cox proportional hazards models and Kaplan-Meier plots examined the effect of caffeine on time to ESRD or death.ResultsCaffeine-by-time was statistically significant when modeling ln(htTKV) in unadjusted and adjusted models (p < 0.01) indicating that caffeine consumers had slightly faster kidney growth (by 0.6% per year), but htTKV remained smaller from baseline throughout the study. Caffeine consumption was not associated with a difference in mGFR, or in the time to ESRD or death (p > 0.05). Moreover the results were similar when outcomes were modeled as a function of caffeine dose.ConclusionWe conclude that caffeine does not have a significant detrimental effect on disease progression in ADPKD.
Highlights
Caffeine has been proposed, based on in vitro cultured cell studies, to accelerate progression of autosomal dominant polycystic kidney disease (ADPKD) by increasing kidney size
CRISP study design and participants Data were taken from the Consortium for Radiologic Imaging Studies of Polycystic Kidney Disease (CRISP) study, which comprised of four clinical centers, University of Alabama, Emory University, University of Kansas and the Mayo Clinic
We computed models based on the inclusion of these patients, with their caffeine intake assumed to be 0 mg, performed additional sensitivity analyses in which these patients were excluded
Summary
Caffeine has been proposed, based on in vitro cultured cell studies, to accelerate progression of autosomal dominant polycystic kidney disease (ADPKD) by increasing kidney size. Autosomal dominant polycystic kidney disease (ADPKD) is a systemic disease that primarily affects the kidneys. ADPKD is the most common inherited kidney disease. This disease causes irreversible kidney damage that begins in utero and Mechanistically, these genetic mutations lead to an abnormal response to high levels of 3′:5′-cyclic adenosine monophosphate (cAMP) when intracellular levels of calcium are low. An increase in cAMP will lead to activation of the ERK signaling pathway which causes an increase in cellular
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