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

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Abstract

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 m2, 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.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available because they contain information that could compromise the privacy of research participants.

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Acknowledgements

This study was supported in part by a Grant-in-Aid for Intractable Renal Diseases Research, Research on Rare and Intractable Diseases, and Health and Labour Sciences Research Grants from the Ministry of Health, Labour and Welfare of Japan. We further acknowledge the support of Dr. Kota Ono from Ono Biostat Consulting (Tokyo, Japan), who provided expert assistance in the statistical analysis.

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Authors and Affiliations

  1. Department of Nephrology, Tokyo Women’s Medical University, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Yusuke Ushio, Hiroshi Kataoka, Masayo Sato, Shun Manabe, Keiko Kawachi, Shiho Makabe, Taro Akihisa, Momoko Seki, Atsuko Teraoka, Naomi Iwasa, Rie Yoshida, Kosaku Nitta, Junichi Hoshino & Toshio Mochizuki

  2. Tokyo Women’s Medical University Institute for Integrated Medical Sciences (TIIMS), Tokyo, Japan

    Hiroyuki Akagawa

  3. Department of Blood Purification, Tokyo Women’s Medical University, Tokyo, Japan

    Ken Tsuchiya

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Correspondence to Hiroshi Kataoka.

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Conflict of interest

Toshio Mochizuki received honoraria for lectures from Otsuka Pharmaceutical Co. Toshio Mochizuki and Hiroshi Kataoka belonged to an endowed department sponsored by Otsuka Pharmaceutical Co., Chugai Pharmaceutical Co., Kyowa Hakko Kirin Co., and JMS Co. The remaining authors have no relevant financial or non-financial interests to disclose.

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The study was approved by the Research Ethics Committee of Tokyo Women’s Medical University (approval number, 5118) and conducted in accordance with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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All procedures were approved by the research ethics committee of Tokyo Women’s Medical University.

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Passive informed consent (in the form of opt-out) was obtained from the patients, and all data were analyzed anonymously.

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Ushio, Y., Kataoka, H., Akagawa, H. et al. Factors associated with early-onset intracranial aneurysms in patients with autosomal dominant polycystic kidney disease. J Nephrol (2024). https://doi.org/10.1007/s40620-023-01866-8

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