Cardiac Structure, Ambulatory Blood Pressure, and Kidney Function in Autosomal Dominant Polycystic Kidney Disease: A Single-Center Cross-Sectional Study

Autosomal dominant polycystic kidney disease (ADPKD) is a multisystem disorder in which progressive cyst growth often coexists with early cardiovascular remodeling. We explored associations of echocardiographic and ambulatory blood pressure indices with kidney function and volume in adults with ADPKD. This single-center retrospective cross-sectional study included 159 consecutive adult patients with ADPKD followed between March 2019 and September 2025. Diagnosis followed the Pei unified ultrasonographic criteria, and kidney function was expressed as the estimated glomerular filtration rate (eGFR) using the CKD-EPI 2009 equation. Cardiac structure was assessed by transthoracic echocardiography, blood pressure load by 24-hour ambulatory blood pressure monitoring (ABPM), and kidney volume by magnetic resonance imaging with Mayo Imaging Classification. Multivariable linear regression and Pearson correlation with Benjamini-Hochberg false discovery rate (FDR) correction were used. Mean age was 49.8 ± 17.6 years; 44.7% were female; hypertension was present in 62.3%. Left ventricular hypertrophy occurred in 38.5% (42/109), more frequently in advanced chronic kidney disease (CKD) stages. In the multivariable regression of echocardiographic parameters on eGFR, left ventricular posterior wall thickness (LVPWT) showed an inverse association with eGFR (β = −9.62 per mm; 95% CI − 14.36 to − 4.90; p < 0.001). Total kidney volume (TKV) correlated positively with all six tested ABPM components ( r = 0.293–0.456; FDR-corrected p ≤ 0.017). Among echocardiographic indices, LVPWT appeared most consistently associated with reduced eGFR. Together with the kidney volume–blood pressure link, these findings suggest echocardiography and ABPM may provide complementary information for cardiorenal evaluation in ADPKD.