Is Regular Screening for Intracranial Aneurysm Necessary in Patients with Autosomal Dominant Polycystic Kidney Disease? A Systematic Review and Meta-analysis

Background: The prevalence of intracranial aneurysm in patients with autosomal dominant polycystic kidney disease (ADPKD) is higher than that among the general population. We performed a systematic review and meta-analysis on the prevalence and natural history of intracranial aneurysm among patients with ADPKD. Methods: Medline, Embase, Web of Science and Scopus, from inception to July 2016, were searched for studies reporting the occurrence of intracranial aneurysms among participants with ADPKD. Two authors independently assessed the eligibility of all retrieved studies and extracted data. Information on the prevalence of intracranial aneurysms and their natural history in participants with ADPKD was collected from all included studies. Results: Fifteen studies with 1,490 participants with ADPKD were pooled to study about the prevalence of intracranial aneurysm in participants with ADPKD, and the prevalence rate was found to be 10% (95% CI 7-13%). Studies from China, Japan and Europe (Germany, Poland) reported a higher prevalence of intracranial aneurysm. Having a family history of haemorrhagic stroke or intracranial aneurysm was a risk factor for aneurysm occurrence. Twenty-three percent (95% CI 15-31%) of the participants had multiple aneurysms. Most of the aneurysms were small (<6 mm) and located in the anterior circulation. Five studies with 171 participants (83 with 106 aneurysms at baseline and 88 without) were analyzed to understand the natural history of aneurysms, with an incidence of aneurysm growth, new aneurysm and aneurysm rupture of 1.84% (followed up for 435 person-years), 0.57% (1,227 person-years) and 0.13% (792 person-years) respectively. Conclusions: Screening for intracranial aneurysm is recommended in patients with ADPKD when there is a family history of haemorrhagic stroke or intracranial aneurysm and when they are from China, Japan or Europe (Germany, Poland). Based on existing data, regular imaging follow-up is not supported. High-quality, prospective studies are needed in the future.

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Natural history of intracranial aneurysms in autosomal dominant polycystic kidney disease

Neurologia i Neurochirurgia Polska ◽

10.1016/j.pjnns.2017.08.007 ◽

2017 ◽

Vol 51 (6) ◽

pp. 476-480 ◽

Cited By ~ 5

Author(s):

Mariusz Niemczyk ◽

Monika Gradzik ◽

Magda Fliszkiewicz ◽

Andrzej Kulesza ◽

Marek Gołębiowski ◽

...

Keyword(s):

Kidney Disease ◽

Natural History ◽

Polycystic Kidney Disease ◽

Intracranial Aneurysms ◽

Autosomal Dominant ◽

Polycystic Kidney ◽

History Of ◽

Autosomal Dominant Polycystic Kidney

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Value of magnetic resonance angiography for the detection of intracranial aneurysms in autosomal dominant polycystic kidney disease.

Journal of the American Society of Nephrology ◽

10.1681/asn.v3121871 ◽

1993 ◽

Vol 3 (12) ◽

pp. 1871-1877 ◽

Cited By ~ 1

Author(s):

J Huston ◽

V E Torres ◽

P P Sulivan ◽

K P Offord ◽

D O Wiebers

Keyword(s):

Subarachnoid Hemorrhage ◽

Family History ◽

Magnetic Resonance ◽

Intracranial Aneurysm ◽

Intracranial Aneurysms ◽

Autosomal Dominant ◽

Three Dimensional ◽

Polycystic Kidney ◽

History Of ◽

Autosomal Dominant Polycystic Kidney

The association of intracranial aneurysms with autosomal dominant polycystic kidney disease (ADPKD), the 30-day mortality rate exceeding 50% for aneurysmal rupture, the effectiveness of surgical repair of unruptured aneurysms with a low surgical risk, and the development of noninvasive imaging techniques for their detection have led physicians to consider the value of screening patients with ADPKD for unruptured intracranial aneurysms. The sensitivity and specificity of high-resolution computed tomography and magnetic resonance imaging for the diagnosis of small intracranial aneurysms have been disappointing. To determine the value of magnetic resonance angiography (MRA), 85 patients with ADPKD without symptoms related to an intracranial aneurysm and 2 patients with ADPKD presenting with a subarachnoid hemorrhage or a suspected aneurysmal leak were studied. MRA was performed with the Multisequence Vascular Package (GE Medical Systems) with use of three-dimensional time-of-flight and three-dimensional phase-contrast techniques, and postprocessing maximum intensity projection images were generated to eliminate the problem of overlapping vessels. Asymptomatic intracranial aneurysms were detected in 6 (22%) of 27 patients with and 3 (5%) of 56 patients without a family history of intracranial aneurysm or subarachnoid hemorrhage (P = 0.02, information missing in 2 patients) and in the 2 patients who presented with a symptomatic aneurysm. A stepwise logistic regression analysis indicated that a family history of intracranial aneurysm or subarachnoid hemorrhage was independently associated with the presence of intracranial aneurysms. All of the aneurysms were < or = 6.5 mm in diameter.(ABSTRACT TRUNCATED AT 250 WORDS)

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Stone Prevalence in Autosomal Dominant Polycystic Kidney Disease: A Systematic Review and Meta-Analysis

Canadian Journal of Kidney Health and Disease ◽

10.1177/2054358120934628 ◽

2020 ◽

Vol 7 ◽

pp. 205435812093462 ◽

Cited By ~ 1

Author(s):

Vinusha Kalatharan ◽

Gary Grewal ◽

Danielle M Nash ◽

Blayne Welk ◽

Sisira Sarma ◽

...

Keyword(s):

Systematic Review ◽

Kidney Disease ◽

Kidney Stones ◽

Methodological Quality ◽

Autosomal Dominant ◽

Meta Analysis ◽

Polycystic Kidney ◽

Cross Sectional ◽

Cross Sectional Studies ◽

Autosomal Dominant Polycystic Kidney

Background: It is uncertain how often patients with autosomal dominant polycystic kidney disease (ADPKD) develop kidney stones. Objective: To review English-language studies reporting the incidence and prevalence of stones and stone interventions in adults with ADPKD. Design: Systematic review and meta-analysis. Setting: Any country of origin. Patients: Adult patients with ADPKD. Measurements: Incidence or prevalence of kidney stones and stone interventions. Methods: We reviewed 1812 citations from bibliographic databases, abstracted data from 49 eligible studies, and assessed methodological quality in duplicate. In some studies, the proportion of adults with ADPKD with the outcome were compared to adults without ADPKD; for these studies, prevalence risk ratios were calculated and pooled using a random effects model. Results: We identified 49 articles that met our review criteria. The methodological quality of many studies was limited (scores ranging from 2 to 14 out of 22, with a higher score indicating higher quality). No study clearly reported stone incidence, and in the cross-sectional studies, the definition of stones was often unclear. The prevalence of stones ranged from 3% to 59%, and a prevalence of stone interventions ranged from 1% to 8%; the average patient age at the time of assessment ranged from 26 to 61 years across the studies. Two studies reported a nonstatistically significant higher stone prevalence in patients with ADPKD compared to unaffected family members. Compared to unaffected family members, patients with ADPKD had a higher prevalence of kidney stones (6 cross-sectional studies; unadjusted prevalence ratio: 1.8; 95% confidence interval: 1.3 to 2.6; P = .0007; test for heterogeneity: I2 = 0%, P = .8). Limitations: Studies were limited to articles published in English. Conclusions: The prevalence of kidney stones and stone interventions in adults with ADPKD remains uncertain. Future studies of higher methodological quality are needed to better characterize the incidence and prevalence of kidney stones in patients with ADPKD. Trial registration: We did not register the protocol for this systematic review.

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