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Presence of simple renal cysts is associated with increased risk of aortic dissection: a common manifestation of connective tissue degeneration?
  1. Eun Kyoung Kim1,
  2. E Ryoung Choi1,
  3. Bong Gun Song1,
  4. Shin Yi Jang1,
  5. Sung Min Ko1,
  6. Seung-Hyuk Choi1,
  7. Jidong Sung1,2,
  8. Kiick Sung3,
  9. Yeon Hyeon Choe4,
  10. Jae K Oh1,5,
  11. Duk-Kyung Kim1
  1. 1Division of Cardiology, Department of Medicine, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
  2. 2Center of Health Promotion, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
  3. 3Department of Thoracic and Cardiovascular surgery, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
  4. 4Department of Radiology and Center for Imaging Science, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
  5. 5Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
  1. Correspondence to Duk-Kyung Kim, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Korea; dkkim{at}skku.edu

Abstract

Objective Aortic dissection is a multifactorial disease whose primary pathology is connective tissue degeneration of the aorta's medial layer. It was hypothesised that the presence of renal cysts, another possible manifestation of connective tissue weakness, would be associated with increased risk of aortic dissection.

Methods The incidence of simple renal cysts on CT angiography in 518 patients with aortic dissection (AD group) and 1366 healthy subjects (control group) who underwent CT for routine health screening was compared. To reduce the effects of selection bias and confounding variables, data were adjusted by propensity score matching.

Results The prevalence of simple renal cysts was 37.8% in the AD group and 22.0% in the control group, a statistically significant difference (p<0.0001). The prevalence of renal cysts was even greater in patients with the following characteristics: intramural haematoma, type B dissection, normal blood pressure or advanced age. In the 311 matched cohorts after propensity score matching, the prevalence of simple renal cysts was still significantly higher in the AD group than in the control group (33.8% vs 25.7%, p=0.023). Multivariate analysis confirmed that the presence of renal cysts (OR 1.49, p=0.0245) could be a marker of having a common underlying mechanism with aortic dissection.

Conclusion Patients with aortic dissection have an increased burden of renal cysts compared with healthy controls. This finding suggests that the connective tissue weakness that predisposes patients to renal cysts may be associated with aortic dissection.

  • Aorta
  • aortic dissection
  • cystic kidneys
  • dissection
  • peripheral vascular disease

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Footnotes

  • Competing interests None.

  • Ethics approval This study was approved by the local institutional review board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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