{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:48:57Z","timestamp":1787028537827,"version":"build-2736575974"},"reference-count":40,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,5,5]],"date-time":"2024-05-05T00:00:00Z","timestamp":1714867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto de Salud Carlos III","award":["PI19\/01220"],"award-info":[{"award-number":["PI19\/01220"]}]},{"name":"Instituto de Salud Carlos III","award":["SLL-PI"],"award-info":[{"award-number":["SLL-PI"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Autosomal polycystic kidney disease (ADPKD) is the most common genetic form of kidney failure, reflecting unmet needs in management. Prescription of the only approved treatment (tolvaptan) is limited to persons with rapidly progressing ADPKD. Rapid progression may be diagnosed by assessing glomerular filtration rate (GFR) decline, usually estimated (eGFR) from equations based on serum creatinine (eGFRcr) or cystatin-C (eGFRcys). We have assessed the concordance between eGFR decline and identification of rapid progression (rapid eGFR loss), and measured GFR (mGFR) declines (rapid mGFR loss) using iohexol clearance in 140 adults with ADPKD with \u22653 mGFR and eGFRcr assessments, of which 97 also had eGFRcys assessments. The agreement between mGFR and eGFR decline was poor: mean concordance correlation coefficients (CCCs) between the method declines were low (0.661, range 0.628 to 0.713), and Bland and Altman limits of agreement between eGFR and mGFR declines were wide. CCC was lower for eGFRcys. From a practical point of view, creatinine-based formulas failed to detect rapid mGFR loss (\u22123 mL\/min\/y or faster) in around 37% of the cases. Moreover, formulas falsely indicated around 40% of the cases with moderate or stable decline as rapid progressors. The reliability of formulas in detecting real mGFR decline was lower in the non-rapid-progressors group with respect to that in rapid-progressor patients. The performance of eGFRcys and eGFRcr-cys equations was even worse. In conclusion, eGFR decline may misrepresent mGFR decline in ADPKD in a significant percentage of patients, potentially misclassifying them as progressors or non-progressors and impacting decisions of initiation of tolvaptan therapy.<\/jats:p>","DOI":"10.3390\/ijms25095036","type":"journal-article","created":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T15:05:01Z","timestamp":1715007901000},"page":"5036","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Measured and Estimated Glomerular Filtration Rate to Evaluate Rapid Progression and Changes over Time in Autosomal Polycystic Kidney Disease: Potential Impact on Therapeutic Decision-Making"],"prefix":"10.3390","volume":"25","author":[{"given":"Rosa","family":"Miquel-Rodr\u00edguez","sequence":"first","affiliation":[{"name":"Nephrology Department, Complejo Hospitalario Universitario de Canarias, 38320 La Laguna, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Gonz\u00e1lez-Toledo","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz UAM, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda-Vanessa","family":"P\u00e9rez-G\u00f3mez","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz UAM, 28040 Madrid, Spain"},{"name":"Department of Medicine, RICORS2040, 28049 Madrid, Spain"},{"name":"Departamento de Medicina, Facultad de Medicina, Universidad Aut\u00f3noma de Madrid, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda \u00c1ngeles","family":"Cobo-Caso","sequence":"additional","affiliation":[{"name":"Nephrology Department, Complejo Hospitalario Universitario de Canarias, 38320 La Laguna, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Delgado-Mall\u00e9n","sequence":"additional","affiliation":[{"name":"Nephrology Department, Complejo Hospitalario Universitario de Canarias, 38320 La Laguna, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Estupi\u00f1\u00e1n","sequence":"additional","affiliation":[{"name":"Nephrology Department, Complejo Hospitalario Universitario de Canarias, 38320 La Laguna, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coriolano","family":"Cruz-Perera","sequence":"additional","affiliation":[{"name":"Laboratory of Renal Function (LFR), Faculty of Medicine, Complejo Hospitalario Universitario de Canarias, University of La Laguna, 38320 La Laguna, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"D\u00edaz-Mart\u00edn","sequence":"additional","affiliation":[{"name":"Laboratory of Renal Function (LFR), Faculty of Medicine, Complejo Hospitalario Universitario de Canarias, University of La Laguna, 38320 La Laguna, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Gonz\u00e1lez-Rinne","sequence":"additional","affiliation":[{"name":"Laboratory of Renal Function (LFR), Faculty of Medicine, Complejo Hospitalario Universitario de Canarias, University of La Laguna, 38320 La Laguna, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Gonz\u00e1lez-Delgado","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Complejo Hospitalario Universitario de Canarias, 38320 La Laguna, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"Torres","sequence":"additional","affiliation":[{"name":"Nephrology Department, Complejo Hospitalario Universitario de Canarias, 38320 La Laguna, Spain"},{"name":"Laboratory of Renal Function (LFR), Faculty of Medicine, Complejo Hospitalario Universitario de Canarias, University of La Laguna, 38320 La Laguna, Spain"},{"name":"Instituto de Tecnolog\u00edas Biom\u00e9dicas (ITB), Faculty of Medicine, University of La Laguna, 38320 La Laguna, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5941-3481","authenticated-orcid":false,"given":"Flavio","family":"Gaspari","sequence":"additional","affiliation":[{"name":"Laboratory of Renal Function (LFR), Faculty of Medicine, Complejo Hospitalario Universitario de Canarias, University of La Laguna, 38320 La Laguna, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domingo","family":"Hern\u00e1ndez-Marrero","sequence":"additional","affiliation":[{"name":"Nephrology Department, Complejo Hospitalario Universitario de Canarias, 38320 La Laguna, Spain"},{"name":"Laboratory of Renal Function (LFR), Faculty of Medicine, Complejo Hospitalario Universitario de Canarias, University of La Laguna, 38320 La Laguna, Spain"},{"name":"Instituto de Tecnolog\u00edas Biom\u00e9dicas (ITB), Faculty of Medicine, University of La Laguna, 38320 La Laguna, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9805-9523","authenticated-orcid":false,"given":"Alberto","family":"Ortiz","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz UAM, 28040 Madrid, Spain"},{"name":"Department of Medicine, RICORS2040, 28049 Madrid, Spain"},{"name":"Departamento de Medicina, Facultad de Medicina, Universidad Aut\u00f3noma de Madrid, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteban","family":"Porrini","sequence":"additional","affiliation":[{"name":"Laboratory of Renal Function (LFR), Faculty of Medicine, Complejo Hospitalario Universitario de Canarias, University of La Laguna, 38320 La Laguna, Spain"},{"name":"Instituto de Tecnolog\u00edas 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