| アブストラクト | RATIONALE & OBJECTIVE: Autosomal dominant polycystic kidney disease (ADPKD) is characterized by a broad range of extrarenal complications, yet epidemiologic data on its association with aortic dissection (AD) or aortic aneurysm (AA) remain limited. In the present study, we assessed whether ADPKD is associated with an increased risk of developing these aortic conditions. STUDY DESIGN: Observational cohort study. SETTING & PARTICIPANTS: 2,568,283 individuals without a history of AD or AA, enrolled between April 2014 and August 2023 in a nationwide Japanese epidemiological database provided by DeSC Healthcare of Tokyo, Japan. EXPOSURE: Presence of ADPKD based on the International Classification of Diseases, Tenth Revision codes. OUTCOME: Incidence of AD or AA. ANALYTICAL APPROACH: Cause-specific hazards models were used to estimate associations (hazard ratios), adjusting for potential confounders. RESULTS: The median age was 68 years (IQR, 61-77), and 1,123,131 individuals (44%) were male. ADPKD was diagnosed in 1,102 individuals (0.04%) within the cohort. During a median follow-up of 1,043 days (IQR: 556-1,600), there were 15,019 occurrences of AD or AA. Multivariable cause-specific hazards models demonstrated that individuals with ADPKD had a significantly increased risk of developing these aortic diseases (HR, 1.76 [95% CI, 1.13-2.73]). When analyzed separately, the HRs were 2.53 (95% CI, 1.13-5.66) for AD and 1.56 (95% CI, 0.94-2.60) for AA. The association of ADPKD with incident AD or AA was more pronounced in individuals with body mass index (BMI) >/= 25 kg/m(2) than in those with BMI < 25 kg/m(2). LIMITATIONS: Potential residual confounding, possible detection bias, and lack of data on ADPKD-causing genetic variant. CONCLUSIONS: Our analysis of a large-scale epidemiological dataset indicated an elevated risk of AD or AA occurrence in individuals with ADPKD. These findings may inform the clinical management of this condition. PLAIN-LANGUAGE SUMMARY: Autosomal dominant polycystic kidney disease (ADPKD) is a common inherited condition that can impair kidney function and affect other organs. Previous studies have suggested that aortic dissection (AD) or aortic aneurysm (AA) may be among its complications, but the evidence has remained inconclusive. We used a nationwide dataset of more than 2.5 million individuals to examine whether individuals with ADPKD are at increased risk of developing AD or AA. Our analyses showed a significant association between ADPKD and these serious aortic disorders. These findings highlight the importance of multidisciplinary efforts to promote prevention, timely recognition, and early intervention for AD or AA in individuals with ADPKD. |
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| ジャーナル名 | American journal of kidney diseases : the official journal of the National Kidney Foundation |
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| Pubmed追加日 | 2026/3/26 |
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| 投稿者 | Nakayama, Takashin; Kaneko, Hidehiro; Suzuki, Yuta; Okada, Akira; Morita, Hiroyuki; Fujiu, Katsuhito; Takeda, Norifumi; Azegami, Tatsuhiko; Yokoo, Takashi; Takeda, Norihiko; Node, Koichi; Yasunaga, Hideo; Nangaku, Masaomi; Hayashi, Kaori |
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| 組織名 | Division of Endocrinology, Metabolism, and Nephrology, Department of Internal;Medicine, Keio University School of Medicine, Tokyo, Japan.;Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan;;Department of Advanced Cardiology, University of Tokyo, Tokyo, Japan. Electronic;address: kanekohidehiro@gmail.com.;Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan; Center;for Outcomes Research and Economic Evaluation for Health, National Institute of;Public Health, Saitama, Japan.;Department of Prevention of Diabetes and Lifestyle-Related Diseases, University;of Tokyo, Tokyo, Japan.;International University of Health and Welfare, Tokyo.;Department of Advanced Cardiology, University of Tokyo, Tokyo, Japan.;Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan.;Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei;University School of Medicine, Tokyo, Japan.;Marfan Syndrome Center, University of Tokyo Hospital, Tokyo, Japan; Department of;Cardiovascular Medicine, University of Tokyo, Tokyo, Japan.;Department of Cardiovascular Medicine, Saga University, Saga, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Division of Nephrology and Endocrinology, The University of Tokyo Graduate School;of Medicine, University of Tokyo, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/41881380/ |
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