Arterial stiffness and choroidal vascularity index in autosomal dominant polycystic kidney disease with preserved kidney function

BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is increasingly recognized as a systemic disorder with early vascular involvement, even before significant kidney function decline. Arterial stiffness and ocular microvascular alterations may reflect subclinical vascular changes in this population. However, data regarding the relationship between systemic arterial stiffness and choroidal microvascular structure in early ADPKD are limited. MATERIALS AND METHODS: ) and age- and sex-matched healthy controls were evaluated. Arterial stiffness was assessed using the cardio-ankle vascular index (CAVI). Ocular structural and microvascular parameters were measured using spectral-domain optical coherence tomography, including the choroidal vascularity index (CVI). Group comparisons, correlation analyses, and multivariable linear regression models were performed to identify independent determinants of CAVI and CVI. RESULTS: CAVI was significantly higher in the ADPKD group compared with controls (p < 0.01). CVI was also significantly increased in patients with ADPKD, whereas subfoveal choroidal thickness did not differ between groups. No significant correlation was observed between CAVI and CVI. In multivariable analyses, ADPKD status remained independently associated with both higher CAVI and higher CVI after adjustment for relevant covariates. CONCLUSION: Patients with early-stage ADPKD exhibit increased systemic arterial stiffness and choroidal microvascular remodeling despite preserved kidney function. The coexistence of elevated CAVI and CVI suggests early, multi-level vascular involvement in ADPKD. Combined assessment of systemic and ocular vascular parameters may provide complementary insights into subclinical vascular alterations in this patient population.