#3682 THE KETONE BODY BETA-HYDROXYBUTYRATE IS ASSOCIATED WITH BETTER KIDNEY FUNCTION OUTCOME IN PATIENTS WITH ADPKD: RESULTS OF THE DIPAK COHORT

Abstract Background and Aims A dysregulated energy metabolism is a key feature of Autosomal Dominant Polycystic Kidney Disease (ADPKD), characterized by cystic cells being dependent on glucose poorly able to use other sources such as ketone bodies. Besides providing energy, bodies, especially beta-hydroxybutyrate, can act signaling metabolites reduce inflammation oxidative stress. In experimental studies, raising body concentration reduced disease progression. Therefore, we hypothesized that higher endogenous serum beta-hydroxybutyrate reduces progression in patients with ADPKD. Method We analyzed data from the DIPAK cohort, prospective observational cohort study included 670 Beta-hydroxybutyrate was measured at baseline using nuclear magnetic resonance spectroscopy. excluded participants type 2 diabetes, who used disease-modifying drugs (e.g., tolvaptan, somatostatin analogs), were not fasting, or had missing leaving 521 for analyses. Linear regression analyses cross-sectional associations linear mixed-effect modeling longitudinal associations. Results The median 94 (IQR 68–147) μmol/L. Of participants, 61% female, mean age 47.3 ± 11.8 years, estimated glomerular filtration rate (eGFR) 63.3 28.9 mL/min/1.73 m2. Cross-sectionally, neither associated eGFR nor kidney volume. Longitudinally, positively slope (B = 0.37 (95% CI 0.11 0.62), p 0.005) but growth. After adjustment potential confounders, every doubling annual loss 0.34 0.10 0.58, ml/min/1.73 Conclusion These support hypothesis concentration, one function decline