Weekly issue 2026-W41 ·
Development of a prediction model for aneurysmal events to guide imaging surveillance in autosomal dominant polycystic kidney disease
Plain language
People with ADPKD are more likely to have brain aneurysms, but there is no agreed plan for how often to re-scan small, untreated ones. Two Japanese centres built a simple 4-point score using three facts: having more than one aneurysm, high blood pressure, and a family history of ADPKD. Over 5 years, no one in the low-risk group had an aneurysm grow, change or bleed, versus nearly half in the high-risk group. It needs testing elsewhere before routine use.
Clinical note
Retrospective two-centre Japanese cohort: of 1,267 ADPKD adults imaged 2003–2024, 132 with untreated intracranial aneurysms and follow-up imaging. Composite outcome: growth, morphological change, de novo formation or rupture. Predictors: multiple aneurysms (OR 5.56), hypertension (OR 3.60) and family history of ADPKD (OR 2.24) → 4-point score; optimism-corrected AUC 0.73. Five-year composite incidence 0% / 12% / 46% (low / moderate / high risk) in validation cohort. Internal validation only, selection bias likely — external validation needed before guiding surveillance intervals.
Question for your next visit
If I have a small brain aneurysm, how would my number of aneurysms, blood pressure and family history affect how often I should be scanned?