Skip to main content
Log in

Etiology and impact on outcomes of polycystic kidney disease in abdominal aortic aneurysm

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

We investigated the etiology and impact on outcomes of polycystic kidney disease in patients with abdominal aortic aneurysm.

Methods

Eight-hundred patients who underwent open (n = 603) or endovascular aortic repair (n = 197) were divided into three groups: no cyst (n = 204), non-polycystic kidney (n = 503), and polycystic kidney (≥ 5 cysts in the bilateral kidneys, n = 93). The characteristics and outcomes were compared among the groups.

Results

In the polycystic kidney group, the age was increased and the proportions of patients with male sex, hypertension, and estimated glomerular filtration rate < 30 mL/min/1.73 m2 were greater. The overall hospital mortality rates were similar. The incidence of acute kidney injury after elective open aortic repair was increased in the polycystic kidney group (12%, 17%, and 29%, P = 0.020). In the polycystic kidney group, 80 patients did not have renal enlargement or a family history of renal disease, while 13 (corresponding to 1.6% [13/800] of the overall patients), had renal enlargement, suggesting the possibility of hereditary polycystic kidney disease.

Conclusions

In our cohort, 1.6% of the patients with abdominal aortic aneurysm who underwent surgery were at risk of hereditary polycystic kidney disease. Polycystic kidney disease was associated with acute kidney injury after open aortic repair.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Forsdahl SH, Singh K, Solberg S, Jacobsen BK. Risk factors for abdominal aortic aneurysms: a 7-year prospective study: the Tromso Study, 1994–2001. Circulation. 2009;119:2202–8.

    Article  Google Scholar 

  2. Wanhainen A, Bergqvist D, Boman K, Nilsson TK, Rutegard J, Bjorck M. Risk factors associated with abdominal aortic aneurysm: a population-based study with historical and current data. J Vasc Surg. 2005;41:390–6.

    Article  Google Scholar 

  3. Ziganshin BA, Theodoropoulos P, Salloum MN, Zaza KJ, Tranquilli M, Mojibian HR, et al. Simple renal cysts as markers of thoracic aortic disease. J Am Heart Assoc. 2016;5:e002248.

    Article  Google Scholar 

  4. Elefteriades JA, Ziganshin BA. Paradigm for detecting silent thoracic aneurysm disease. Semin Thorac Cardiovasc Surg. 2016;28:776–82.

    Article  Google Scholar 

  5. Takagi H, Umemoto T, ALICE (All-Literature Investigation of Cardiovascular Evidence) Group. Simple renal cyst and abdominal aortic aneurysm. J Vasc Surg. 2016;63:254–9.

    Article  Google Scholar 

  6. Spanos K, Rountas C, Saleptsis V, Athanasoulas A, Fezoulidis I, Giannoukas AD. The association of simple renal cysts with abdominal aortic aneurysms and their impact on renal function after endovascular aneurysm repair. Vascular. 2016;24:150–6.

    Article  CAS  Google Scholar 

  7. Horie S, Mochizuki T, Muto S, Hanaoka K, Fukushima Y, Narita I, et al. Evidence-based clinical practice guidelines for polycystic kidney disease 2014. Clin Exp Nephrol. 2016;20:493–509.

    Article  Google Scholar 

  8. Dhanani J, Mullany DV, Fraser JF. Effect of preoperative renal function on long-term survival after cardiac surgery. J Thorac Cardiovasc Surg. 2013;146:90–5.

    Article  Google Scholar 

  9. Kellum JA, Lameire N, Group KAGW. Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (part 1). Crit Care. 2013;17:204.

    Article  Google Scholar 

  10. Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982–92.

    Article  CAS  Google Scholar 

  11. Hansen KL, Nielsen MB, Ewertsen C. Ultrasonography of the kidney: a pictorial review. Diagnostics (Basel). 2015;6:2.

    Article  Google Scholar 

  12. Chebib FT, Torres VE. Autosomal dominant polycystic kidney disease: core curriculum 2016. Am J Kidney Dis. 2016;67:792–810.

    Article  Google Scholar 

  13. Nonaka T, Kimura N, Hori D, Sasabuchi Y, Nakano M, Yuri K, et al. Predictors of acute kidney injury following elective open and endovascular aortic repair for abdominal aortic aneurysm. Ann Vasc Dis. 2018;11:298–305.

    Article  Google Scholar 

  14. Kanda Y. Investigation of the freely available easy-to-use software 'EZR' for medical statistics. Bone Marrow Transpl. 2013;48:452–8.

    Article  CAS  Google Scholar 

  15. Ozveren B, Onganer E, Turkeri LN. Simple renal cysts: prevalence, associated risk factors and follow-up in a health screening cohort. Urol J. 2016;13:2569–75.

    PubMed  Google Scholar 

  16. Yaghoubian A, de Virgilio C, White RA, Sarkisyan G. Increased incidence of renal cysts in patients with abdominal aortic aneurysms: a common pathogenesis? Ann Vasc Surg. 2006;20:787–91.

    Article  Google Scholar 

  17. Gindera LB, Donas KP, Torsello G, Bisdas T, Stavroulakis K. Significant CT-angiographic evidence of coexisting abdominal aortoiliac aneurysms with simple renal cysts and abdominal wall hernias. Minerva Chir. 2015;70:409–16.

    CAS  PubMed  Google Scholar 

  18. Bisceglia M, Galliani CA, Senger C, Stallone C, Sessa A. Renal cystic diseases: a review. Adv Anat Pathol. 2006;13:26–56.

    Article  Google Scholar 

  19. Barua M, Pei Y. Diagnosis of autosomal-dominant polycystic kidney disease: an integrated approach. Semin Nephrol. 2010;30:356–65.

    Article  CAS  Google Scholar 

  20. Rahbari-Oskoui F, O'Neill WC. Diagnosis and management of acquired cystic kidney disease and renal tumors in ESRD patients. Semin Dial. 2017;30:373–9.

    Article  Google Scholar 

  21. Ecder T, Schrier RW. Cardiovascular abnormalities in autosomal-dominant polycystic kidney disease. Nat Rev Nephrol. 2009;5:221–8.

    Article  CAS  Google Scholar 

  22. Blair HA. Tolvaptan: a review in autosomal dominant polycystic kidney disease. Drugs. 2019;79:303–13.

    Article  CAS  Google Scholar 

  23. Solazzo A, Testa F, Giovanella S, Busutti M, Furci L, Carrera P, et al. The prevalence of autosomal dominant polycystic kidney disease (ADPKD): a meta-analysis of European literature and prevalence evaluation in the Italian province of Modena suggest that ADPKD is a rare and underdiagnosed condition. PLoS ONE. 2018;13:e0190430.

    Article  Google Scholar 

  24. Willey C, Kamat S, Stellhorn R, Blais J. Analysis of nationwide data to determine the incidence and diagnosed prevalence of autosomal dominant polycystic kidney disease in the USA: 2013–2015. Kidney Dis. 2019;5:107–17.

    Article  Google Scholar 

  25. Chapman AB, Stepniakowski K, Rahbari-Oskoui F. Hypertension in autosomal dominant polycystic kidney disease. Adv Chronic Kidney Dis. 2010;17:153–63.

    Article  Google Scholar 

  26. Chapman AB, Guay-Woodford LM, Grantham JJ, Torres VE, Bae KT, Baumgarten DA, et al. Renal structure in early autosomal-dominant polycystic kidney disease (ADPKD): the consortium for radiologic imaging studies of polycystic kidney disease (CRISP) cohort. Kidney Int. 2003;64:1035–45.

    Article  Google Scholar 

  27. Gabow PA, Johnson AM, Kaehny WD, Kimberling WJ, Lezotte DC, Duley IT, et al. Factors affecting the progression of renal disease in autosomal-dominant polycystic kidney disease. Kidney Int. 1992;41:1311–9.

    Article  CAS  Google Scholar 

  28. Chin HJ, Ro H, Lee HJ, Na KY, Chae DW. The clinical significances of simple renal cyst: is it related to hypertension or renal dysfunction? Kidney Int. 2006;70:1468–73.

    Article  CAS  Google Scholar 

  29. Longo GM, Xiong W, Greiner TC, Zhao Y, Fiotti N, Baxter BT. Matrix metalloproteinases 2 and 9 work in concert to produce aortic aneurysms. J Clin Investig. 2002;110:625–32.

    Article  CAS  Google Scholar 

  30. Harada H, Furuya M, Ishikura H, Shindo J, Koyanagi T, Yoshiki T. Expression of matrix metalloproteinase in the fluids of renal cystic lesions. J Urol. 2002;168:19–22.

    Article  Google Scholar 

  31. Perrone RD, Malek AM, Watnick T. Vascular complications in autosomal dominant polycystic kidney disease. Nat Rev Nephrol. 2015;11:589–98.

    Article  CAS  Google Scholar 

  32. Kim K, Drummond I, Ibraghimov-Beskrovnaya O, Klinger K, Arnaout MA. Polycystin 1 is required for the structural integrity of blood vessels. Proc Natl Acad Sci USA. 2000;97:1731–2176176.

    Article  CAS  Google Scholar 

  33. Terada N, Ichioka K, Matsuta Y, Okubo K, Yoshimura K, Arai Y. The natural history of simple renal cysts. J Urol. 2002;167:21–3.

    Article  Google Scholar 

  34. Lee CT, Yang YC, Wu JS, Chang YF, Huang YH, Lu FH, et al. Multiple and large simple renal cysts are associated with prehypertension and hypertension. Kidney Int. 2013;83:924–30.

    Article  CAS  Google Scholar 

  35. Bang JY, Lee JB, Yoon Y, Seo HS, Song JG, Hwang GS. Acute kidney injury after infrarenal abdominal aortic aneurysm surgery: a comparison of AKIN and RIFLE criteria for risk prediction. Br J Anaesth. 2014;113:993–1000.

    Article  CAS  Google Scholar 

  36. Castagno C, Varetto G, Quaglino S, Frola E, Scozzari G, Bert F, et al. Acute kidney injury after open and endovascular elective repair for infrarenal abdominal aortic aneurysms. J Vasc Surg. 2016;64:928–33.

    Article  Google Scholar 

  37. Yokoyama N, Nonaka T, Kimura N, Sasabuchi Y, Hori D, Matsunaga W, et al. Acute kidney injury following elective open aortic repair with suprarenal clamping. Ann Vas Dis. 2020. (Epub ahead of print).

  38. Talhar SS, Waghmare JE, Paul L, Kale S, Shende MR. Computed tomographic estimation of relationship between renal volume and body weight of an individual. J Clin Diagn Res. 2017;11:AC04–AC8.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Naoyuki Kimura.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest in association with the present study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (DOC 844 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nakano, M., Kimura, N., Nonaka, T. et al. Etiology and impact on outcomes of polycystic kidney disease in abdominal aortic aneurysm. Surg Today 50, 1213–1222 (2020). https://doi.org/10.1007/s00595-020-01997-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-020-01997-6

Keywords

Navigation