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The Prevalence, Mechanisms, and Clinical Significance of Inferior Vena Cava Compression in Autosomal Dominant

Ahmad Matarneh1, Bayan Matarneh2, Abdelrauof Akkari1

  • 1Division of Nephrology, Department of Medicine, Penn State Health, Milton S. Hershey Medical Center, Hershey, PA 17033, USA.

Medicina (Kaunas, Lithuania)
|January 28, 2026
PubMed

Insights

Inferior vena cava (IVC) compression in autosomal dominant polycystic kidney disease (ADPKD) significantly worsens patient outcomes. This complication increases the risk of end-stage renal disease (ESRD), raises mortality rates, and reduces overall survival.

Area of Science:

  • Nephrology
  • Vascular Medicine
  • Genetics

Background:

  • Autosomal dominant polycystic kidney disease (ADPKD) is a primary cause of end-stage renal disease (ESRD).
  • Progressive renal cyst growth in ADPKD can lead to mass effects, including inferior vena cava (IVC) compression.
  • IVC compression is a rare but significant complication impacting hemodynamic stability and renal outcomes.

Purpose of the Study:

  • To evaluate the prevalence of IVC compression in ADPKD patients.
  • To assess the impact of IVC compression on progression to ESRD, mortality, and overall survival.
  • To provide quantitative measures of the prognostic significance of IVC compression in ADPKD.

Main Methods:

  • Retrospective cohort study using the TriNetX database.
  • Inclusion of 658 ADPKD patients with IVC compression, compared to controls without compression.
  • Analysis of outcomes including ESRD incidence, mortality, and survival using Kaplan-Meier curves and hazard ratios (HRs).

Main Results:

  • IVC compression was associated with a 2.61-fold increased risk of ESRD (77.4% vs. 29.7%).
  • Five-year survival was significantly reduced in patients with IVC compression (42.6% vs. 61.7%), with a hazard ratio of 4.00.
  • Mortality was higher in the compression group (29.2% vs. 9.1%), and ESRD patients with IVC compression had a 5.60-fold higher mortality risk.

Conclusions:

  • IVC compression in ADPKD is linked to substantially worse clinical outcomes.
  • Early diagnosis and targeted management of IVC compression are crucial for improving patient prognosis.
  • Findings highlight the prognostic importance of IVC compression in ADPKD progression and survival.

Keywords:
autosomal dominant polycystic kidney disease (ADPKD)end-stage renal disease (ESRD)inferior vena cava compressionvenous thrombosis

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