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MR Brain Screening in ADPKD Patients : To Screen or not to Screen?
I Capelli1, M Zoli2,3, M Righini1
1Nephrology, Dialysis and Renal Transplant Unit, IRCCS - Azienda Ospedaliero Universitaria di Bologna, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
Clinical Neuroradiology
|September 29, 2021
Summary
Adult polycystic kidney disease (ADPKD) patients have a higher prevalence of intracranial aneurysms (IA) and other brain abnormalities. Brain MRI screening in ADPKD patients, even without a family history, is recommended due to frequent findings.
Area of Science:
- Nephrology
- Neurology
- Genetics
Background:
- Adult polycystic kidney disease (ADPKD) is a leading cause of renal failure.
- Intracranial aneurysms (IA) are more prevalent in ADPKD patients.
- Current guidelines recommend brain MRI for IA screening only in those with a family history of IA or subarachnoid hemorrhage (SAH).
Purpose of the Study:
- To evaluate the utility of brain MRI screening in ADPKD patients.
- To compare the prevalence of brain abnormalities in ADPKD patients versus a non-ADPKD population.
- To identify factors correlating with IA and other brain abnormalities in ADPKD.
Main Methods:
- Retrospective case-control analysis of ADPKD patients undergoing brain MRI (2016-2019).
- Comparison of IA and other brain abnormalities prevalence with a control group (n=300).
- Univariate and multivariate regression analysis of demographic, clinical, laboratory, and genetic factors.
Main Results:
- ADPKD patients had a significantly higher prevalence of IAs (13.6%) compared to controls (5.3%).
- Most IAs in ADPKD patients (70.6%) occurred without a family history of IA or SAH.
- Arachnoid cysts (AC) and arterial variants were more frequent in ADPKD patients; PKD1 mutations were associated with IAs.
Conclusions:
- ADPKD patients exhibit increased prevalence of IAs, AC, and arterial variants.
- PKD1 mutations are frequently associated with IAs in ADPKD patients.
- Brain MRI screening should be reconsidered for ADPKD patients, including those without a family history of IA or SAH.
