Prevalence of pericardial effusion in autosomal dominant polycystic kidney disease

Abstract

Background Autosomal dominant polycystic kidney disease (ADPKD) has numerous extrarenal manifestations. Pericardial effusion (PE) may be an under-recognized complication with a reported prevalence of up to 35%. Our study is the first to systematically evaluate the prevalence of PE and associated risk factors in an ADPKD cohort outside the U.S. Methods Clinically stable ADPKD patients from a specialized outpatient clinic were evaluated retrospectively. Magnetic resonance tomography and computed tomography scans were analysed regarding the presence of PE (≥4 mm). Imaging results were linked to clinical characteristics. Results Out of 286 ADPKD patients, 208 had computed tomography or magnetic resonance imaging suitable for evaluation of PE. In this group, we detected PE in 17 patients (8.2%). The overall prevalence of PE was 6.3% with more females being affected (prevalence of PE 7.8% in female and 3.8% in male patients). PE mean size was 6.8 ± 3.3 mm. The prevalence of autoimmune diseases was higher in the patients with PE (11.8% versus 2.1%, P = 0.022), while presence and size of PE was not associated with signs of rapid progressive disease, ADPKD genotype, patient age, BMI, and other clinical parameters. Exploratory investigation of individual characteristics of PE patients by regression tree analysis suggested renal functional impairment, sex, and proteinuria as candidate variables. Conclusions PE prevalence in our cohort was lower than previously reported and showed a clear female preponderance. Our data suggest that patients with PE size > 10 mm deserve further attention, as they may have additional non-ADPKD related pathologies.