マナベ シユン   Manabe Shiyun
  眞部 俊
   所属   医学部 医学科(東京女子医科大学病院)
   職種   講師
言語種別 英語
発表タイトル Sex Differences and Aging Influence the Association between Kidney Prognosis and Intracranial Aneurysms in Patients with ADPKD: Attribute-Based Medicine (ABM) Insights
会議名 Kidney Week 2024
主催者 American Society of Nephrology
学会区分 国際学会及び海外の学会
発表形式 ポスター掲示
講演区分 一般
発表者・共同発表者◎Ushio Yusuke, Kataoka Hiroshi, Mochizuki Toshio, Manabe Shun, Seki Momoko, Makabe Shiho, Tsuchiya Ken, Nitta Kosaku, Hoshino Junichi,
発表年月日 2024/10/26
国名 アメリカ合衆国
開催地
(都市, 国名)
San Diego, USA
開催期間 2024/10/24~2024/10/27
概要 Background
There is a recognized tendency for intracranial aneurysms (IAs) to occur more frequently in elderly women. We aimed to elucidate the association of IAs on kidney disease progression in ADPKD patients, taking into account age and sex as pivotal factors.
Methods
Our study included 494 patients with ADPKD. Renal outcome, defined as a 50% reduction in estimated glomerular filtration rate or initiation of renal replacement therapy, was evaluated using Cox regression analysis and Kaplan-Meier analysis.
Results
Multivariable Cox analyses indicated that IAs were significantly associated with kidney disease progression across the entire cohort (hazard ratio [HR]=1.93). Sub-group analyses showed significant associations between IAs and kidney disease progression in men with <50 years (HR=3.93) and in women ≥50 years (HR=3.63). Kaplan–Meier analysis demonstrated that kidney survival rates were significantly lower in patients with IAs compared to those without, across all cohorts. The 5-year renal survival rate of ADPKD patients with IAs was 51.2% for the entire cohort, 73.5% for women <50 years, 46.2% for men <50 years, 39.9% for women ≥50 years, and 37.5% for men ≥50 years, indicating a extremely poor renal prognosis.
Conclusion
IAs were associated with a poor renal prognosis in patients with ADPKD, especially in men <50 years and women ≥50 years. Susceptibility to IAs in ADPKD patients varies by age and sex. Younger patients are primarily affected by genetic mutations, while older patients, particularly elderly women, may be influenced by a combination of genetic mutations and lifestyle factors, potentially impacting their kidney prognosis.