Carbohydrate antigen 19-9 is significantly elevated in autosomal dominant polycystic kidney disease

Nephrology (Carlton). 2018 Mar;23(3):210-216. doi: 10.1111/nep.12988.

Abstract

Aim: Liver cysts are the most common extrarenal manifestation in patients with autosomal dominant polycystic kidney disease (ADPKD). Carbohydrate antigen 19-9 (CA19-9) is generally used as a marker for biliopancreatic malignancies, although CA19-9 levels in patients with ADPKD are largely unknown.

Methods: A prospective observational study of 53 ADPKD patients and 83 non-ADPKD control subjects was performed. The serum levels of CA19-9 were studied to evaluate the association with clinical parameters and liver cysts.

Results: The serum CA19-9 levels were significantly higher in the ADPKD group than in the control group (32.9 U/mL vs. 9.8 U/mL, respectively, P < 0.001). The serum CA19-9 levels in the ADPKD group were positively correlated with the mean blood pressure (rho = 0.335, P < 0.05), gamma-glutamyl transferase (GTP) levels (rho = 0.541, P < 0.001), the largest cyst size (rho = 0.536, P < 0.001) and the liver cyst volume (rho = 0.682, P < 0.001). Multiple regression analyses showed that the gamma-GTP levels (P < 0.001) and the liver cyst volumes (P < 0.001) were independent predictors for serum CA19-9 levels.

Conclusions: Serum CA19-9 levels are significantly elevated and appear to be dependent on the gamma-GTP levels and the volume of liver cysts in patients with ADPKD. Our findings indicate that the measurement of the baseline CA19-9 level in each patient with ADPKD may be useful for the interpretation of the value and the differential diagnosis of liver diseases, particularly the liver cyst infection.

Keywords: autosomal dominant polycystic kidney disease (ADPKD); carbohydrate antigen 19-9 (CA19-9); cyst volume; gamma-glutamyl transferase (GTP); liver cysts.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • CA-19-9 Antigen / blood*
  • Case-Control Studies
  • Cysts / blood*
  • Cysts / diagnostic imaging
  • Cysts / physiopathology
  • Diagnosis, Differential
  • Female
  • Humans
  • Liver Diseases / blood*
  • Liver Diseases / diagnostic imaging
  • Liver Diseases / physiopathology
  • Male
  • Middle Aged
  • Polycystic Kidney, Autosomal Dominant / blood*
  • Polycystic Kidney, Autosomal Dominant / diagnosis
  • Polycystic Kidney, Autosomal Dominant / physiopathology
  • Polycystic Kidney, Autosomal Dominant / therapy
  • Predictive Value of Tests
  • Prospective Studies
  • Renal Dialysis
  • Tomography, X-Ray Computed
  • Up-Regulation
  • gamma-Glutamyltransferase / blood

Substances

  • CA-19-9 Antigen
  • gamma-Glutamyltransferase
  • gamma-glutamyltransferase, human

Supplementary concepts

  • Polycystic liver disease