Predictors of cerebral microbleeds in patients with autosomal dominant polycystic kidney disease.

ABSTRACT

OBJECTIVES: Individuals with autosomal dominant polycystic kidney disease (ADPKD) can present with vascular abnormalities, including intracranial aneurysms. However, whether ADPKD is associated with cerebral small-vessel disease, such as cerebral microbleeds (CM), remains unclear. The study analyzes the prevalence of CM and the associated clinical and radiological factors in patients with ADPKD. METHODS: The retrospective study enrolled 140 consecutive patients with ADPKD from July 2014 to May 2023. Brain MRIs were analyzed for the presence of CM with susceptibility-weighted imaging (SWI), which were categorized based on lesion location (lobar, deep, or infratentorial). RESULT: In this study, the prevalence of CM is 26.4%. Chronic kidney disease (CKD) stage (odds ratio [OR] 1.40, 95% confidence interval [CI] 1.04-1.88, p = 0.027) and leukoaraiosis grade (OR 3.29, 95% CI 1.43-7.56, p = 0.005) were strongly associated with CM. Additionally, both CKD stage (OR 1.48, 95% CI 1.06-2.07, p = 0.023) and leukoaraiosis grade (OR 2.81, 95% CI 1.30-6.05, p = 0.008) were associated with lobar microbleeds, whereas only leukoaraiosis grade was also related to deep (OR 9.00, 95% CI 3.06-26.44, p < 0.001) and infratentorial (OR 2.48, 95% CI 1.10-5.61, p = 0.029) microbleeds. The prediction model based on age, CKD stage and leukoaraiosis grade had diagnostic performance with area under curve 0.804, 0.688, 0.697, respectively. CONCLUSION: We recommend that patients with ADPKD who are aged 58 or older, and who have CKD of at least stage 3, undergo brain MRI for detection of CM.