Weekly issue 2026-W37 ·
Validation of Prognostic Tools for Autosomal Dominant Polycystic Kidney Disease Progression in a Multiethnic South African Cohort
Plain language
In a multiethnic South African ADPKD group, doctors tested simple bedside clues — age, sex, early high blood pressure, urinary events, and ultrasound kidney length — when MRI and genetic tests were hard to get. Those clinical tools still helped spot who was more likely to reach kidney failure, especially among Black patients. Where Mayo imaging class and MRI are available, they remain the preferred risk tools.
Clinical note
Retrospective multiethnic ADPKD cohort (n=276; 54% Black). Modified clinical PROPKD (no genotype) predicted ESKD (high-risk HR 4.34, 95% CI 2.88–6.71); US kidney length >16.5 cm HR 1.87. Discrimination moderate overall (AUC 0.66 vs length 0.61) but highest in Black patients (AUC 0.78) vs White (AUC 0.51). Pragmatic adjunct where Mayo/MRI/genotype unavailable — does not replace Mayo imaging classification where accessible.
Question for your next visit
If MRI or genetic testing is not available to me, what can my history and ultrasound tell us about my kidney risk, and what remains uncertain?