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PKD1-Associated Arachnoid Cysts in Autosomal Dominant Polycystic Kidney Disease
Kaori Shigemori1, Eiji Higashihara2, Masayuki Itoh3
1Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.
Insights
Autosomal dominant polycystic kidney disease (ADPKD) patients with PKD1 mutations have a higher risk of developing arachnoid cysts. This study investigated the link between PKD genotypes and brain abnormalities in ADPKD.
Area of Science:
- Neurology
- Genetics
- Nephrology
Background:
- Autosomal dominant polycystic kidney disease (ADPKD) is associated with a higher prevalence of intracranial aneurysms and arachnoid cysts.
- While a genotype correlation exists for intracranial aneurysms in ADPKD, its association with arachnoid cysts remains unclear.
Purpose of the Study:
- To investigate the genotype correlation of intracranial aneurysms and arachnoid cysts in patients with autosomal dominant polycystic kidney disease (ADPKD).
Main Methods:
- 169 ADPKD patients underwent magnetic resonance imaging (MRI) for screening of intracranial aneurysms and arachnoid cysts.
- Next-generation sequencing was used to determine PKD genotypes (PKD1, PKD2, or no mutation).
Main Results:
- Arachnoid cysts were diagnosed significantly earlier in patients with PKD1 mutations compared to PKD2 mutations (54.8 vs 67.7 years).
- The proportional hazard risk for arachnoid cysts was 5.0 times higher in the PKD1 group than in the PKD2 group.
- No significant difference in the frequency or diagnosis age of intracranial aneurysms was observed between PKD1 and PKD2 groups.
Conclusions:
- A significant correlation exists between arachnoid cysts and PKD1 mutations in ADPKD patients.
- The association of arachnoid cysts with advanced renal disease in ADPKD may be linked to the common correlation with PKD1 mutations.
Objectives:
the prevalence of intracranial aneurysms and arachnoid cysts is higher in patients with autosomal dominant polycystic kidney disease (ADPKD) than in the general population. A genotype correlation was reported for intracranial aneurysms, but it is unclear for arachnoid cysts. Therefore, the genotype correlation with intracranial aneurysms and arachnoid cysts was investigated in ADPKD.
Materials And Methods:
intracranial aneurysms and arachnoid cysts were screened by magnetic resonance imaging (MRI), and PKD genotypes were examined using next-generation sequencing for 169 patients with ADPKD.
Results:
PKD1-, PKD2- and no-mutation were identified in 137, 24 and 8 patients, respectively. Intracranial aneurysms and arachnoid cysts were found in 34 and 25 patients, respectively, with no significant difference in frequency. Genotype, sex, estimated glomerular filtration rate and age at ADPKD diagnosis significantly affected the age at brain MRI. The proportional hazard risk analyzed using the age at brain MRI adjusted by these four variables was 5.0-times higher in the PKD1 group than in the PKD2 group for arachnoid cysts (P = 0.0357), but it was not different for intracranial aneurysms (P = 0.1605). Arachnoid cysts were diagnosed earlier in the PKD1 group than in the PKD2 group (54.8 vs 67.7 years, P = 0.0231), but no difference was found for intracranial aneurysms (P = 0.4738) by Kaplan-Meier analysis.
Conclusions:
this study demonstrated the correlation between arachnoid cysts and PKD1 mutation. The reported association of arachnoid cysts with advanced renal disease may be due to the common correlation of these factors with PKD1 mutation.
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