1. Diagnosis and Risk Factors for Intracranial Aneurysms in Autosomal Polycystic Kidney Disease: A cross-sectional study from the Genkyst Cohort
- Author
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Siriane, Lefèvre, Marie-Pierre, Audrézet, Jean-Michel, Halimi, Hélène, Longuet, Frank, Bridoux, Laure, Ecotière, Jean-François, Augusto, Agnès, Duveau, Eric, Renaudineau, Cécile, Vigneau, Thierry, Frouget, Christophe, Charasse, Lorraine, Gueguen, Régine, Perrichot, Grégoire, Couvrat, Guillaume, Seret, Yannick, Le Meur, Emilie, Cornec-Le Gall, S, Martin, Génétique, génomique fonctionnelle et biotechnologies (UMR 1078) (GGB), EFS-Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), CH de Saint-Malo [Broussais], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), École des Hautes Études en Santé Publique [EHESP] (EHESP), CHU Pontchaillou [Rennes], Centre hospitalier Saint-Brieuc, Centre Hospitalier Intercommunal de Cornouaille (CHIC), Centre hospitalier Bretagne Atlantique (Morbihan) (CHBA), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon (CHD Vendée), Association ECHO [Expansion des Centres d’Hémodialyse de l’Ouest], Lymphocytes B, Autoimmunité et Immunothérapies (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-LabEX IGO Immunothérapie Grand Ouest, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Institut Brestois Santé Agro Matière (IBSAM), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), and Chard-Hutchinson, Xavier
- Subjects
Male ,subarachnoid hemorrhage ,PKD2 ,PKD1 ,urologic and male genital diseases ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,Humans ,risk factors ,genetics ,[SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] ,Aged ,autosomal dominant polycystic kidney disease (ADPKD) ,Polycystic Kidney Diseases ,Transplantation ,intracranial aneurysms ,Intracranial Aneurysm ,Estrogens ,Polycystic Kidney, Autosomal Dominant ,[SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,female genital diseases and pregnancy complications ,Cross-Sectional Studies ,Nephrology ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Female ,[SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie - Abstract
Background Autosomal dominant polycystic kidney disease (ADPKD) is associated with an increased risk for developing intracranial aneurysms (IAs). We aimed to evaluate the frequency of diagnosis of IAs in the cross-sectional, population-based, Genkyst cohort, to describe ADPKD-associated IAs and to analyse the risk factors associated with the occurrence of IAs in ADPKD patients. Methods A cross-sectional study was performed in 26 nephrology centres from the western part of France. All patients underwent genetic testing for PKD1/PKD2 and other cystogenes. Results Among the 2449 Genkyst participants, 114 (4.65%) had a previous diagnosis of ruptured or unruptured IAs at inclusion, and ∼47% of them had a positive familial history for IAs. Most aneurysms were small and saccular and located in the anterior circulation; 26.3% of the patients had multiple IAs. The cumulative probabilities of a previous diagnosis of IAs were 3.9%, 6.2% and 8.1% at 50, 60 and 70 years, respectively. While this risk appeared to be similar in male and female individuals 2-fold higher in PKD1 compared with PKD2, with no influence of PKD1 mutation type or location. In multivariate analysis, female sex, hypertension Conclusions This study presents epidemiological data reflecting real-life clinical practice. The increased risk for IAs in postmenopausal women suggests a possible protective role of oestrogen.
- Published
- 2022
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