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Repeat Imaging for Intracranial Aneurysms in Patients with Autosomal Dominant Polycystic Kidney Disease with Initially Negative Studies: A Prospective Ten-Year Follow-up

Robert W. Schrier^*, Mark M. Belz^*, Ann M. Johnson^*, William D. Kaehny, Richard L. Hughes^,||, David Rubinstein and Patricia A. Gabow^¶

Departments of *Medicine, Neurology, and Radiology, University of Colorado School of Medicine, Medical Service, Veterans Affairs Medical Center, and ^||Division of Neurology and ^¶Department of Medicine, Denver Health Medical Center, Denver, Colorado.

Correspondence to Dr. Robert W. Schrier, University of Colorado Health Sciences Center, C283, 4200 E Ninth Avenue, Denver, CO 80262. Phone: 303-315-7821; Fax: 303-315-5253; E-mail: Robert.Schrier{at}uchsc.edu

ABSTRACT. Patients with autosomal dominant polycystic kidney disease (ADPKD) have a higher incidence of intracranial aneurysms (ICA) than the general population. These ICA also rupture at an earlier age in patients with ADPKD and are associated with high morbidity and mortality. In a recent study, 25% of patients with ADPKD with a documented ICA demonstrated a new ICA on follow-up. It is not known, however, whether patients with ADPKD who have had a negative ICA imaging study would demonstrate an ICA on a repeat imaging study. Only 2 (2.6%) of 76 patients with ADPKD with an initially negative study demonstrated an ICA on follow-up, despite the high frequency of risk factors such as hypertension, smoking, and a family history of ruptured ICA. The mean length of follow-up was 9.8 yr (median, 9.7 yr). These findings have important health care and economic implications in following patients with ADPKD.

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Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673