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- Intracranial aneurysms in autosomal dominant polycystic kidney disease
- Jung Hyun Park
- Kosin Med J. 2024;39(4):281-289. Published online December 6, 2024
- DOI: https://doi.org/10.7180/kmj.24.138
- 1,223 View
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Abstract
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- Background
The incidence of intracranial aneurysms (ICA) is high in patients with autosomal dominant polycystic kidney disease (ADPKD). However, little is known regarding the optimal screening and treatment methods for ICA.
Methods
This study investigated the characteristics of ADPKD patients with ICA, analyzing each variable according to whether the ICA ruptured, and examined the outcomes according to the treatment method. Specifically, a retrospective study was conducted on the treatment of ICA patients with ADPKD at a single institution for 10 years, from 2013 to 2022.
Results
The mean age of the 17 enrolled ADPKD patients with ICA was 57.4 years. Surgical and endovascular treatment methods were used in four and 13 patients. Eleven patients had unruptured ICAs, and the remaining six patients had suffered subarachnoid hemorrhage (SAH). Two patients experienced neurological deficits after discharge. All patients with unruptured ICAs were discharged without any complications, although one of them underwent additional treatment 5 years later. Four patients with SAH had known ADPKD at the time of diagnosis (67%). As for the treatment method, 13 patients were treated with coiling. In a comparison of variables between unruptured ICA and SAH patients, the location of the ICA showed a statistically significant difference (p<0.05).
Conclusions
In ADPKD patients, diagnostic screening for the detection of ICA is essential, and with appropriate management, interventional endovascular treatment may be a good treatment option.
- The Natural Course of Total Kidney Volume in Patients with Autosomal Dominant Polycystic Kidney Disease undergoing Hemodialysis
- Ye Na Kim, Yeonsoon Jung, Ho Sik Shin, Hark Rim, Jung Gu Park, Dong Yeol Lee, Joong Kyung Kim
- Kosin Med J. 2021;36(2):109-115. Published online December 31, 2021
- DOI: https://doi.org/10.7180/kmj.2021.36.2.109
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Abstract
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Objectives The natural course of native kidneys after hemodialysis initiation in patients with autosomal dominant polycystic kidney disease (ADPKD) remains poorly understood.
Methods We measured the total volumes of native kidneys in 12 patients who had at least one enhanced computed tomography (CT) image both before and after initiation of hemodialysis (group 1) and in 18 patients who had no image before dialysis but more than two images after dialysis (group 2). In patients with images, the last image was used for analysis only after dialysis.
Results The mean total kidney volume (TKV) (± SD) before hemodialysis initiation was 3132 ± 1413 mL and the mean TKV of the last image was 3047 ± 1323 mL in group 1. The mean TKV change rate (%) was −5.2 ± 27.4% (
P > 0.05) during follow-up of 3.9 ± 1.9 years in group 1. The mean TKV change rate was 2.8 ± 34.4% (P > 0.05) in group 2. The follow-up period after dialysis initiation ranged from 4.2 ± 4.7 to 8.0 ± 5.2 years.Conclusions The results suggest that the TKV of native polycystic kidneys decreases substantially after hemodialysis initiation. This reduction occurs mainly during the early post-hemodialysis period and followed by a slow enlargement of TKV.
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