Intracranial Aneurysms in Autosomal Dominant Polycystic Kidney

BACKGROUND AND PURPOSE: ADPKD correlates with an increased frequency of ICANs, but universal screening for ICANs in patients with ADPKD is not currently recommended. The aim of our study was to determine which groups might benefit from screening by determining the prevalence of ICANs in the Polish ADPKD population and identifying any subgroups with an increased risk for ICANs. MATERIALS ANDMETHODS: Eighty-three adult, predialysis-phase patients with ADPKD underwent screening for ICANswithMRA of the brain. RESULTS: The prevalence of ICANs in the studied population was 16.9%, with 6 % of the screened group requiring neurosurgical interven-tion. We also found that the frequency of ICANs increases with age, reaching 22.4 % in patients older than 45 years. All diagnosed ICANs were small ( 9mm) andwere localized in the anterior circulation. In addition,MR imaging revealed arachnoid cysts in 4.8%of patientswith ADPKD. CONCLUSIONS: We suggest that patients older than 45 years with ADPKD be considered as candidates for screening for ICANs, and we propose a clinical algorithm for this subgroup. However, we could not find risk factors for ICANs in younger patients with ADPKD. ABBREVIATIONS: ADPKD autosomal dominant polycystic kidney disease; AH arterial hypertension; CKD chronic kidney disease; ICAN intracranial aneurysm; CI, confidence interval ADPKD is themost commonmonogenic disease, affecting 1 ofevery 1000 people. However, although ADPKD leads to end