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2017 ; 8
(34
): 57594-57604
Nephropedia Template TP
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Risk of aortic aneurysm and dissection in patients with autosomal-dominant
polycystic kidney disease: a nationwide population-based cohort study
#MMPMID28915698
Sung PH
; Yang YH
; Chiang HJ
; Chiang JY
; Chen CJ
; Liu CT
; Yu CM
; Yip HK
Oncotarget
2017[Aug]; 8
(34
): 57594-57604
PMID28915698
show ga
Although cardiovascular complications are the most common cause of death in
patients with autosomal-dominant polycystic kidney disease (ADPKD), the incidence
and risk of aortic aneurysm and dissection (AAD) in ADPKD remains unclear due to
limited data and insufficient cases. We utilized the data from Taiwan National
Health Insurance Research Database (NHIRD) to do a population-based cohort study
(1997-2008). After excluding those patients with age <18 years old and initially
concomitant diagnoses of end-stage renal disease and AAD, a total of 2076 ADPKD
patients were selected from 1,000,000 of general population. Additionally, the
non-ADPKD group was set up as comparison group in 1:10 ratio after matching with
age, gender, income and urbanization (n=20760). The result showed that ADPKD
group had higher frequency of comorbidities than non-ADPKD group. The frequency
of AAD in ADPKD was significantly higher than in general population (0.92% v.s.
0.11%, p<0.0001). Of them, 58% of AAD were acute aortic dissection. In addition,
Kaplan-Meier analysis demonstrated that cumulative incidence of AAD was
remarkably higher in the ADPKD than non-ADPKD group (p<0.001). The mean time
period from ADPKD diagnosis to AAD occurrence was 4.02±3.16 years. After
adjusting for age, gender and comorbidities, the ADPKD patients had up to
5.49-fold greater risk for AAD occurrence as compared to non-ADPKD counterparts
(95% CI 2.86-10.52, p<0.0001). Particularly, those patients with co-existing
ADPKD and hypertension had very high risk for future development of AAD. In
conclusion, the risk of AAD significantly increases in patients with ADPKD as
compared with those of general population.