Screening for intracranial aneurysms in autosomal dominant polycystic kidney disease

Area of Science:

• Nephrology
• Neurology
• Radiology

Background:

• Autosomal dominant polycystic kidney disease (ADPKD) is associated with an increased risk of intracranial aneurysms.
• Screening for asymptomatic intracranial aneurysms in ADPKD patients has been suggested to prevent rupture, morbidity, and mortality.

Purpose of the Study:

• To evaluate the risk-benefit profile of screening ADPKD patients for intracranial aneurysms.
• To determine if current evidence supports routine screening in asymptomatic individuals without a history of subarachnoid hemorrhage (SAH).

Main Methods:

• Review of recent studies on aneurysm rupture rates.
• Analysis of complication risks associated with aneurysm interventions.
• Risk-benefit assessment of screening protocols.

Main Results:

• Recent data indicate lower spontaneous rupture rates for small aneurysms than previously thought.
• Interventional treatment of aneurysms carries higher complication risks than previously reported.
• Risk-benefit analysis does not support screening in ADPKD patients without a history of SAH.

Conclusions:

• Current evidence does not demonstrate a benefit from screening ADPKD patients without a history of SAH for intracranial aneurysms.
• Screening may lead to harm due to the risks associated with diagnostic and interventional procedures.
• Further research and careful consideration of individual patient risk factors are warranted.