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Kidney Week

Abstract: SA-PO752

Prevalence and Characteristics of Intracranial Aneurysms and Cerebral Hemorrhage in Patients with Autosomal Dominant Polycystic Kidney Disease in the Japanese Nationwide Database

Session Information

Category: Genetic Diseases of the Kidneys

  • 1201 Genetic Diseases of the Kidneys: Cystic

Authors

  • Ushio, Yusuke, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan
  • Kataoka, Hiroshi, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan
  • Shimada, Yosuke, Juntendo Daigaku, Bunkyo-ku, Tokyo, Japan
  • Nishio, Saori, Hokkaido Daigaku, Sapporo, Hokkaido, Japan
  • Mochizuki, Toshio, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan
  • Manabe, Shun, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan
  • Tsuchiya, Ken, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan
  • Nitta, Kosaku, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan
  • Hoshino, Junichi, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan
  • Kimura, Tomonori, Reverse Translational Research Project, National Institutes of Biomedical Innovation, Health and Nutrition (NIBIOHN), Ibaraki, Osaka, Japan
  • Narita, Ichiei, Niigata Daigaku, Niigata, Niigata, Japan
  • Muto, Satoru, Juntendo Daigaku, Bunkyo-ku, Tokyo, Japan
Background

Selective screening for cerebral aneurysms in patients with autosomal dominant polycystic kidney disease (ADPKD) is recommended worldwide. In this study, we analyzed data from a cohort of Japanese patients with ADPKD, for which universal screening is recommended. We describe the prevalence and characteristics of intracranial aneurysms and cerebral hemorrhage in patients with ADPKD.

Methods

We examined the nationwide registry data of 4447 patients with ADPKD who held a new certificate of medical subsidy from the Japanese Ministry of Health, Labor, and Welfare from 2015 to 2017. We investigated the screening rates and risk factors for intracranial aneurysms, and prevalence of intracranial aneurysms and intracranial hemorrhage in patients with ADPKD. To analyze the diagnostic rate of intracranial aneurysms, we also compared the prevalence of intracranial aneurysms between patients who received MRI and those who did not.

Results

Overall, 693 patients (15.6%) had intracranial aneurysms, and 256 (5.8%) had intracranial hemorrhage. The MRI screening rate for intracranial aneurysms in patients with intractable diseases was 78.2%. The prevalence of intracranial aneurysms in patients who underwent MRI increased to 19.2% (odds ratio [OR] =9.33) compared with that in patients who did not (2.5%). The prevalence of intracranial aneurysms in MRI-screened patients was 22.6% in patients aged ≥ 50 years, 19.4% in patients with hypertension, and 21.5% in female patients. Hypertension (OR=1.46; P=0.002), age ≥ 50 years (OR=1.39; P < 0.001), female sex (OR=1.52; P < 0.001), and CKD stages 4–5 (OR=1.29; P=0.005) were risk factors associated with intracranial aneurysms. Female sex was found to interact with age and was not a risk factor for intracranial aneurysms in patients under 50 years of age but was a risk factor for intracranial aneurysms in those over 50 years of age (P < 0.05 for the interaction).

Conclusion

Screening with MRI improved the diagnostic rate of intracranial aneurysms in patients with ADPKD, which is particularly important for attributes at risk for intracranial aneurysms such as patients aged ≥50 years, with hypertension, female sex, and CKD stages 4–5.