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ADPKD Risk Stratification and Future eGFR Prediction

Risk Stratification Data

Converted to metres for the height-adjusted TKV calculation.

Clinical Data

Classification

Height-adjusted TKV
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Mayo imaging class
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eGFR

Current
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Projected
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Interpretation

Enter values above to see interpretation.

Projected eGFR Trajectory

No projection yet Complete the fields above to plot a trajectory.

Only the first and last points are model estimates. Intermediate years are drawn by straight-line interpolation between them; the true trajectory of eGFR decline is not linear, so the years in between are illustrative rather than predictive.

Methods and Limitations

Imaging classification
Height-adjusted total kidney volume (htTKV) is compared against the Mayo Clinic ADPKD imaging classification thresholds for the patient's age. The classification applies only to typical (Class 1) diffuse, bilateral disease in patients aged 18 to 80, and assumes kidney volume was measured by a validated method such as MRI or CT with ellipsoid or stereological volumetry.
Current eGFR
Calculated using the CKD-EPI 2009 creatinine equation, including the race coefficient. This equation has been superseded in routine US practice by the race-free CKD-EPI 2021 equation and will differ from the eGFR reported by most clinical laboratories. It is retained here because the projection below was developed against CKD-EPI 2009 values; substituting a different equation would invalidate the projection.
Projected eGFR
A population-level regression estimate based on age, sex, imaging class, current eGFR and the selected time horizon. It describes the average trajectory of patients with similar characteristics and does not account for blood pressure, treatment (including tolvaptan), genotype, proteinuria or other individual factors. Individual outcomes vary substantially around this estimate, and no confidence interval is shown.
Intended use
This tool supports clinical discussion and is not a diagnostic device. Results should be interpreted by a clinician alongside the full clinical picture and should not be used on their own to make treatment decisions.

About this Calculator

This calculator is designed to help healthcare providers assess and predict the progression of Autosomal Dominant Polycystic Kidney Disease (ADPKD). It combines two essential predictive tools:

  • The Mayo Clinic imaging classification system for ADPKD, which categorizes patients into classes 1A-1E based on height-adjusted total kidney volume (htTKV)
  • A validated eGFR prediction model that estimates future kidney function based on current clinical parameters

How to Use:

  1. Enter the total kidney volume and patient demographics in the left panel
  2. Provide clinical data including serum creatinine in the right panel
  3. Specify the desired prediction timeframe in years
  4. Results will automatically calculate and display below

Mayo Clinic Classification Guide

  • Class 1A: Slowest progression (<1.5% growth/year)
  • Class 1B: Slow progression (1.5-3% growth/year)
  • Class 1C: Intermediate progression (3-4.5% growth/year)
  • Class 1D: Rapid progression (4.5-6% growth/year)
  • Class 1E: Fastest progression (>6% growth/year)

Note: This tool is intended for use by healthcare professionals as part of a comprehensive clinical assessment. Results should be interpreted in conjunction with other clinical findings.

References

ADPKD Classification and Imaging

  • Mayo Clinic Foundation for Medical Education and Research (MFMER). "Classification of Typical ADPKD Calculator." Mayo Clinic PKD Center (2015). Available at: https://www.mayo.edu/research/documents/pkd-center-adpkd-classification/doc-20094754
  • Irazabal, M.V., et al. "Imaging classification of autosomal dominant polycystic kidney disease: a simple model for selecting patients for clinical trials." Journal of the American Society of Nephrology 26.1 (2015): 160-172.
  • Chapman, A.B., et al. "Kidney volume and functional outcomes in autosomal dominant polycystic kidney disease." Clinical Journal of the American Society of Nephrology 7.3 (2012): 479-486.

Height-Adjusted Total Kidney Volume

  • Bhutani, H., et al. "A practical guide to imaging and monitoring autosomal dominant polycystic kidney disease." Clinical Journal of the American Society of Nephrology 15.8 (2020): 1208-1217.
  • Grantham, J.J., et al. "Total kidney volume in autosomal dominant polycystic kidney disease: a biomarker of disease progression and therapeutic efficacy." American Journal of Kidney Diseases 72.3 (2018): 389-399.

Clinical Applications

  • Torres, V.E., et al. "Tolvaptan in patients with autosomal dominant polycystic kidney disease." New England Journal of Medicine 367.25 (2012): 2407-2418.
  • Cornec-Le Gall, E., et al. "The PROPKD Score: A new algorithm to predict renal survival in autosomal dominant polycystic kidney disease." Journal of the American Society of Nephrology 27.3 (2016): 942-951.
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