Association of simple renal cysts and chronic kidney disease with large abdominal aortic aneurysm

Milena Miszczuk,Andrea Stroux,Helena Kuivaniemi,Irene Hinterseher,Verena Müller,Andy Dobberstein,Christian E Althoff,Daniela Widhalm,Andreas Greiner

doi:10.1186/s12882-020-01841-6

Abstract

BackgroundAbdominal aortic aneurysms (AAA) primarily affect men over 65 years old who often have many other diseases, with similar risk factors and pathobiological mechanisms to AAA. The aim of this study was to assess the prevalence of simple renal cysts (SRC), chronic kidney disease (CKD), and other kidney diseases (e.g. nephrolithiasis) among patients presenting with AAA.MethodsTwo groups of patients (97 AAA and 100 controls), with and without AAA, from the Surgical Clinic Charité, Berlin, Germany, were selected for the study. The control group consisted of patients who were evaluated for a kidney donation (n = 14) and patients who were evaluated for an early detection of a melanoma recurrence (n = 86). The AAA and control groups were matched for age and sex. Medical records were analyzed and computed tomography scans were reviewed for the presence of SRC and nephrolithiasis.ResultsSRC (74% vs. 57%; p<0.016) and CKD (30% vs. 8%; p<0.001) were both more common among AAA than control group patients. On multivariate analysis, CKD, but not SRC, showed a strong association with AAA.ConclusionsKnowledge about pathobiological mechanisms and association between CKD and AAA could provide better diagnostic and therapeutic approaches for these patients.

Highlights

Abdominal aortic aneurysms (AAA) primarily affect men over 65 years old who often have many other diseases, with similar risk factors and pathobiological mechanisms to AAA
As AAA is asymptomatic in the majority of cases [6], it is often initially detected as an incidental finding during ultrasound or computed tomography (CT) examinations
The main findings of our study were that chronic kidney disease (CKD) was more frequent in AAA than age- and sex-matched control patients and showed a strong association with AAA in multivariable analysis, which included ever smoker, peripheral artery disease (PAD), pack years, incisional hernia, any hernia, congestive heart failure, American Society of Anesthesiologists (ASA) score, diabetes mellitus, coronary bypass, creatinine, chronic obstructive pulmonary disease (COPD), current smoker, coronary artery disease, diverticulosis, platelet count and simple renal cysts (SRC)

Summary

Introduction

Abdominal aortic aneurysms (AAA) primarily affect men over 65 years old who often have many other diseases, with similar risk factors and pathobiological mechanisms to AAA. The prevalence of AAA has decreased in the last decades and is 1–2% [2]. This change can be primarily attributed to a decreased prevalence of smoking [2, 3]. One way to reduce this trend, is to implement a national AAA screening program to detect AAA before rupture [10]. Such a program was launched successfully in the USA in 2007 [11] and in the Great Britain in 2009 [12]

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