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Kidney Week

Abstract: SA-PO0549

Intracranial Aneurysms and Hemorrhages in ADPKD: An Attribute-Based Cross-Classification Analysis in a Nationwide Japanese Cohort

Session Information

Category: Genetic Diseases of the Kidneys

  • 1201 Genetic Diseases of the Kidneys: Monogenic Kidney Diseases

Authors

  • Kataoka, Hiroshi, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan
  • Shimada, Yosuke, Juntendo Daigaku Igakubu Daigakuin Igaku Kenkyuka, Bunkyo, Tokyo, Japan
  • Hoshino, Junichi, Tokyo Joshi Ika Daigaku, Shinjuku, Tokyo, Japan
  • Nishio, Saori, Hokkaido Daigaku, Sapporo, Hokkaido Prefecture, Japan
  • Hiromura, Keiju, Gunma Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Maebashi, Gunma Prefecture, Japan
  • Isaka, Yoshitaka, Osaka Daigaku, Suita, Osaka Prefecture, Japan
  • Muto, Satoru, Juntendo Daigaku Igakubu Fuzoku Nerima Byoin, Nerima, Tokyo, Japan
Background

The prevalence and risk factors for intracranial aneurysm (IA) and intracranial hemorrhage (ICH) in patients with autosomal dominant polycystic kidney disease (ADPKD) remain incompletely defined, particularly regarding demographic and clinical attributes. This study aimed to clarify the prevalence of IA and ICH in a large ADPKD cohort from Japan, where universal neuroimaging screening is recommended.

Methods

We analyzed data from 4,447 Japanese patients with ADPKD registered in a national database between 2015 and 2017. The presence of IA and ICH was assessed, and associations with clinical variables evaluated using logistic regression. We also conducted cross-classification analyses to explore attribute-based prevalence patterns.

Results

Overall, 693 patients (15.6%) had IA, increasing to 19.2% among those who underwent magnetic resonance angiography. ICH was observed in 256 patients (5.8%). Risk factors significantly associated with IA included female sex (OR=1.52, P<0.001), hypertension (OR=1.46, P=0.002), age ≥50 years (OR=1.39, P<0.001), and CKD stages 4–5 (OR=1.29, P=0.005). For ICH, only hypertension was significant (OR=1.83, P=0.003). An interaction between female sex and age ≥50 was noted for IA (P=0.022), indicating female sex was a risk factor only in older patients. Cross-classification revealed a high IA prevalence in women aged ≥50 (27.7%) and those with CKD stages 4–5 (28.8%).

Conclusion

This analysis of the world’s largest ADPKD cohort highlights the substantial prevalence of IA and ICH in Japanese patients and underscores the importance of attribute-based risk stratification. These findings support individualized screening, particularly in older women and those with advanced CKD.

IA Prevalence in ADPKD

Digital Object Identifier (DOI)