Abstract
Autosomal dominant polycystic kidney disease (ADPKD) has been associated with cardiac abnormalities including mitral valve prolapse and aneurysmal dilatation of the aortic root. Herein, we investigated the potential association of pericardial effusion with ADPKD. Subjects with ADPKD (n = 117) and control subjects without ADPKD matched for age, gender and renal function (n = 117) undergoing MRI including ECG-gated cine MRI of the aorta and heart were evaluated for pericardial effusion independently by three observers measuring the maximum pericardial effusion thickness in diastole using electronic calipers. Pericardial effusion thickness was larger in ADPKD subjects compared to matched controls (Mann–Whitney p = 0.001) with pericardial effusion thickness >5 mm observed in 24 of 117 (21%) ADPKD subjects compared to 4 of 117 (3%) controls (p = 0.00006). Pericardial effusion thickness in ADPKD was associated with female gender patients (1.2 mm greater than in males, p = 0.03) and pleural effusion thickness (p < 0.001) in multivariate analyses. No subjects exhibited symptoms related to pericardial effusion or required pericardiocentesis. In conclusion, pericardial effusion appears to be more prevalent in ADPKD compared to controls. Although in this retrospective cross-sectional study we did not identify clinical significance, future investigations of pericardial effusion in ADPKD subjects may help to more fully understand its role in this disease.
Highlights
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary cause of chronic kidney disease [1,2,3] and affects the cardiovascular system with hypertension, intracranial aneurysms, dolichoectasia of the carotid arteries, mitral valve prolapse and aneurysmal dilatation of the aortic root and proximal aorta [4,5,6,7,8]
Pericardial effusion > 5 mm was more prevalent in ADPKD subjects compared to controls (24 of 117 (21%) vs. 4 of 117 (3%), p < 0.001) (Table 2)
Summary
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary cause of chronic kidney disease [1,2,3] and affects the cardiovascular system with hypertension, intracranial (berry) aneurysms, dolichoectasia of the carotid arteries, mitral valve prolapse and aneurysmal dilatation of the aortic root and proximal aorta [4,5,6,7,8]. We have incidentally noted pericardial effusions in ADPKD subjects while evaluating magnetic resonance imaging (MRI) of research subjects in the Rogosin Institute PKD Repository. We determined the prevalence of pericardial effusion in ADPKD subjects on MRI compared to a control population without ADPKD matched for age, gender and kidney function.
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