Factors associated with early-onset intracranial aneurysms in patients with autosomal dominant polycystic kidney disease

• Published in: Journal of nephrology Vol. 37; no. 4; pp. 983 - 992
• Main Authors: Ushio, Yusuke, Kataoka, Hiroshi, Akagawa, Hiroyuki, Sato, Masayo, Manabe, Shun, Kawachi, Keiko, Makabe, Shiho, Akihisa, Taro, Seki, Momoko, Teraoka, Atsuko, Iwasa, Naomi, Yoshida, Rie, Tsuchiya, Ken, Nitta, Kosaku, Hoshino, Junichi, Mochizuki, Toshio
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.05.2024
• Subjects: Medicine; Medicine & Public Health; Nephrology; Original Article; Urology; Young stroke; Attribute-based medicine; Sex difference; Juvenile-onset; Autosomal dominant polycystic kidney disease; Intracranial aneurysm
• ISSN: 1724-6059; 1724-6059
• DOI: 10.1007/s40620-023-01866-8

Background Recently, the importance of attribute-based medicine has been emphasized. The effects of early-onset intracranial aneurysms on patients can be significant and long-lasting. Herein, we compared the factors associated with intracranial aneurysms in patients with autosomal dominant polycystic kidney disease (ADPKD) according to age categories (≥ 50 years, < 50 years). Methods We included 519 ADPKD patients, with a median age of 44 years, estimated glomerular filtration rate of 54.5 mL/min/1.73 m 2 , and total follow-up duration of 3104 patient-years. Logistic regression analyses were performed to determine factors associated with intracranial aneurysms. Results Regarding the presence of intracranial aneurysm, significant interactions were identified between the age category (age ≥ 50 years), female sex ( P  = 0.0027 for the interaction) and hypertension ( P  = 0.0074 for the interaction). Female sex and hypertension were associated with intracranial aneurysm risk factors only in patients aged ≥ 50 years. The presence of intracranial aneurysm was significantly associated with chronic kidney disease (CKD) stages 4–5 (odds ratio [OR] = 3.87, P  = 0.0007) and family history of intracranial aneurysm or subarachnoid hemorrhage (OR = 2.30, P  = 0.0217) in patients aged < 50 years. For patients aged ≥ 50 years, in addition to the abovementioned factors [OR = 2.38, P  = 0.0355 for CKD stages 4–5; OR = 3.49, P  = 0.0094 for family history of intracranial aneurysm or subarachnoid hemorrhage], female sex (OR = 4.51, P  = 0.0005), and hypertension (OR = 5.89, P  = 0.0012) were also associated with intracranial aneurysm. Conclusion Kidney dysfunction and family history of intracranial aneurysm or subarachnoid hemorrhage are risk factors for early-onset intracranial aneurysm. Patients aged < 50 years with a family history of intracranial aneurysm or subarachnoid hemorrhage or with CKD stages 4–5 may be at an increased risk of early-onset intracranial aneurysm. Graphical abstract