The Impact of Autosomal Dominant Polycystic Kidney Disease on the Presence of Cerebral Microbleeds: A Case-Control Matched Study.

RATIONALE AND OBJECTIVES

Individuals with autosomal dominant polycystic kidney disease (ADPKD) can present with diverse renal and extra-renal manifestations. Large vessel anomalies, such as cerebral aneurysms, are potentially fatal extra-renal manifestations. However, limited research has been conducted on cerebral small vessel disease (CSVD). This study aimed to examine the correlation between ADPKD and CSVD, specifically cerebral microbleeds (CMs) and white matter hyperintensity (WMH).

MATERIALS AND METHODS

This retrospective study with a prospective design included 140 participants aged >20 years diagnosed with ADPKD between 2014 and 2023. The reference cohort included 126 outpatients without ADPKD within the same period. After 1:1 matching for sex, age, chronic kidney disease (CKD) stage, and hypertension (HTN) status during the same period, 45 pairs of patients were enrolled. Cerebral magnetic resonance imaging was reviewed for qualitative and quantitative analyses of CMs and WMH.

RESULTS

There were significant differences between the ADPKD and non-ADPKD groups in the presence of cerebral (p=0.036) and deep microbleeds (p=0.003). Univariate and multivariable analysis revealed that ADPKD (odds ratio [OR]: 6.18, 95% confidence interval [CI]: 1.26-30.40, p=0.025) and age (OR: 1.10, 95% CI: 1.04-1.18, p=0.003) were independently associated with CMs. In contrast, age (OR: 1.19, 95% CI: 1.05-1.34, p=0.006) was independently associated with moderate-to-severe WMH, while ADPKD was not.

CONCLUSION

Individuals diagnosed with ADPKD exhibited markedly elevated susceptibility to CMs compared to non-ADPKD participants after adjusting for age, sex, HTN, and CKD stage.