The Need for Intracranial Aneurysm Screening in Autosomal Dominant Polycystic Kidney Disease : An Updated Systematic Review and Meta-Analysis
Patricio Castro Suarez1, Claudia Cruzalegui Bazán1, Lucero del Pilar Peltroche Ramos1, Kevin Capra Sanabria1, Carlos Rodrigo Vicuña2
1Sociedad Científica de San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru, 2Grupo de Investigación Neurociencias, Metabolismo, Efectividad Clínica y Sanitaria (NEMECS), Universidad Científica del Sur, Lima, Perú
Objective:
To provide an updated review of the literature on the need for intracranial aneurysm (IA) screening in patients with autosomal dominant polycystic kidney disease (ADPKD) by synthesizing the latest prevalence data.
Background:
ADPKD is associated with an increased risk of IAs, which represents a significant threat due to the potential for rupture and subsequent subarachnoid hemorrhage. Despite this known risk, there is an ongoing debate regarding the necessity of routine screening for IAs in ADPKD patients.
Design/Methods:
We systematically search PubMed, Embase, Scopus, Web of Science until September, 2024. Two authors assessed independently each study and extracted data. We evaluate the risk of bias using NewCastle Ottawa Scale. A meta-analysis using a random effects model was employed to calculate the pooled prevalence of IAs in ADPKD patients
Results:
A total of 23 studies comprising 7,087 participants were included in this meta-analysis, with 8 newly identified studies. The overall prevalence of IAs was 11.0% (95%CI: 8.0%-14.0%; I2 = 91%), with a higher proportion in Japan (18.0%; 9 studies; 943 participants; 95%CI: 13.0%-23.0%; I2 = 53%). High prevalence was also reported in Poland with 16.87% (1 study, 95%CI: 9.49% - 25.76%) and South Korea with 15.98% (1 study, 95%CI: 13.69% - 18.42%).
Conclusions:
IAs appear to have a higher prevalence in patients with ADPKD compared to the general population, particularly in certain regions such as Japan, Poland, and South Korea. These findings could justify the decision of imaging screening; however, prospective cohorts and cost-effectiveness studies are needed to support this clinical decision.
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