Other Risk Factors

Overweight and Obesity

Obesity was associated with nearly four times greater adjusted odds of progressing at an annual rate of change in TKV of 7% compared with < 5%. Obesity was also independently associated with greater eGFR decline (slope) versus normal weight.1

  • Four hundred forty-one participants with early ADPKD who participated in HALT-PKD Study A, were included in the analysis of the association of overweight and obesity with change in TKV.
  • Participants were categorized by baseline BMI*:
    • Normal weight: 18.5–24.9 kg/m2 (n=192)
    • Overweight: 25.0–29.9 kg/m2 (n=168)
    • Obese: 30 kg/m2 (n=81)
  • Overweight and obesity was associated with increased odds of annual percent change in TKV 7% compared with < 5% (overweight: OR, 2.02; 95% CI, 1.15 to 3.56; obese: OR, 3.76; 95% CI, 1.81 to 7.80)+.
Annual % Change in TKV

Albuminuria and Proteinuria in ADPKD

CRISP cohort provided longitudinal evidence for associations between elevated albumin-to-creatinine ratio (ACR), increased TKV and decreased eGFR22


  • Microalbuminuria is more common than proteinuria, occurring in 35% of ADPKD individuals.2
  • Direct evidence that reducing albuminuria in ADPKD affects progression to ESKD is not currently available3
    • Some evidence that an elevated ACR is a risk factor for progressive disease and should be included in the decision to target lower blood pressures and increase the dose of RAAS inhibitors.3


  • Dipstick-detectable proteinuria occurs in <18% with most demonstrating <1 g/24 h.2
  • Overt proteinuria is uncommon in ADPKD, with only 27% demonstrating 300 mg/d.4
  • Proteinuria >2 g/d is unusual and suggests the presence of another kidney disease.4

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