ツチヤ　ケン   TSUCHIYA Ken   土谷　健    所属   医学部 医学科（東京女子医科大学病院）    職種   客員教授
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Middle cerebral artery aneurysms in older women with autosomal dominant polycystic kidney disease.
掲載誌名	正式名：Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 略　 称：Nephrol Dial Transplant ISSNコード：14602385/09310509
掲載区分	国外
巻・号・頁	pp.online
著者・共著者	Kataoka Hiroshi, Manabe Shun, Ushio Yusuke, Akagawa Hiroyuki, Seki Momoko, Sato Masayo, Kawachi Keiko, Makabe Shiho, Akihisa Taro, Teraoka Atsuko, Iwasa Naomi, Yoshida Rie, Otsubo Shigeru, Hanafusa Norio, Tsuchiya Ken, Nitta Kosaku, Hoshino Junichi, Toshio Mochizuki
発行年月	2025/05/31
概要	BACKGROUND AND HYPOTHESIS:Sex and age impact on intracranial aneurysms (IAs) in patients with autosomal dominant polycystic kidney disease (ADPKD) remains unclear. We explored IA characteristics in patients with ADPKD using sex- and age-based cross-classification methods.METHODS:We retrospectively reviewed the medical records of 586 outpatients with ADPKD who visited the Kidney Centre at Tokyo Women's Medical University Hospital between July 2003 and July 2019. After excluding 67 patients, 519 were included in the final analysis. The associations of IA with sex, age, hypertension, family history of IA/subarachnoid haemorrhage (SAH), chronic kidney disease (CKD) stages, and kidney volume were examined.RESULTS:Significant sex differences were found in patients with IA. Women had a higher distribution of anterior circulation IAs, including middle cerebral artery (MCA) aneurysms (62.7% vs. 44.8%), and experienced SAH at an older age (46 vs. 37.5 years) than men. In sex-specific analyses, CKD stages IV-V and family history of IA/SAH were associated with IA in men and women; however, hypertension was associated with IA only in women. When IAs were cross-classified by sex and age (≥50 years), significant differences were observed, particularly in the MCA, where women aged ≥ 50 years had a higher distribution than men (40.5% vs. 5.9%, odds ratio [OR]=10.88). These location-specific differences were not observed in patients aged < 50 years. Analyses of ageing effects in patients with ADPKD revealed that compared to men, women aged ≥ 50 years had a higher risk of hypertension (OR = 4.11) and MCA aneurysms (OR = 5.93) than those aged < 50 years. MCA aneurysms in women aged ≥ 50 years were associated with hypertension (OR = 8.27).CONCLUSION:Sex and age significantly affect IA development in patients with ADPKD, highlighting the significance of hypertension in older women at risk of MCA aneurysms.
DOI	10.1093/ndt/gfaf095
PMID	40448707