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A
ssociation
between
renal
cysts
and
abdominal
aortic
aneurysm
: A
case
-
control
study
R
ev
A
ssoc
M
ed
B
ras
2017; 63(8):681-684
681
ORIGINAL ARTICLE
Association between renal cysts and abdominal aortic aneurysm:
A case-control study
H
élio
M
iguel
de
A
zevêdo
B
ião
V
eiga
1
, L
eandro
J
osé
C
orreia
da
S
ilva
2
, C
arlos
H
enrique
S
uzuki
B
ellucci
2
, M
arcus
V
inicius
M
iranda
dos
S
antos
2
, R
icardo
B
rianezi
T
iraboschi
2
, V
ictor
P
ereira
P
aschoalin
2
, L
ucas
B
orba
2
, C
ristiano
M
endes
G
omes
2,3
,
J
osé
M
urillo
B
astos
-N
etto
2,4
, J
osé
de
B
essa
J
unior
1,2
*
1
Division of Urology, Medical School, Universidade Estadual de Feira de Santana (UEFS), Feira de Santana, BA, Brazil
2
Urology Research Group (Uros), UEFS, Feira de Santana, BA, Brazil
3
Division of Urology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
4
Department of Surgery, Universidade Federal de Juiz de Fora (UFJF) and Hospital e Maternidade Therezinha de Jesus, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (HMTJ/Suprema), Juiz de Fora, MG, Brazil
S
ummary
Study conducted at Universidade
Estadual de Feira de Santana (UEFS),
Feira de Santana, BA, Brazil
Article received:
May 2017
Accepted for publication:
July 2017
*Correspondence:
Address: Av. Transnordestina, s/n
Feira de Santana, BA – Brazil
Postal code: 44036-900
bessa@uefs.br http://dx.doi.org/10.1590/1806-9282.63.08.681Objective:
To investigate the positive association between the presence of simple
renal cysts (SRCs) and abdominal aortic aneurysm (AAA).
Method:
In a retrospective case-control study including subjects aged > 50 years,
we evaluated the incidence of SRCs on computed tomography (CT) scan. We
compared 91 consecutive patients with AAA referred from the Division of Vascular
Surgery and 396 patients without AAA, randomly selected after being matched
by age and gender from 3,186 consecutive patients who underwent abdominal
CT. SRC was defined as a round or oval low-attenuation lesion with a thin wall
and size > 4 mm on CT without obvious evidence of radiographic enhancement
or septations. Patients were considered as having AAA if the size of aorta was
greater than 3.0 cm.
Results:
Patients with AAA and without AAA were similar in terms of age (67.9±
8.41 vs. 68.5±9.13 years) (p=0.889) and gender (71.4 vs. 71.2% of male subjects,
respectively) (p=0.999). There was no difference in the prevalence of SRC between
case and controls. Among individuals with AAA, 38 (41.8%; [95CI 32.5-52.6])
had renal cysts compared to 148 (37.4%; [95CI 32.7-42.2]) in the control group
(p=0.473), with a prevalence ratio (PR) of 1.16 (95CI 0.80-1.68).
Conclusion:
We found no significant differences in the prevalence of SRCs
among patients with AAA and controls. Our findings suggest that the presence
of SRCs is not a risk factor or a marker for AAA.
Keywords:
cystic kidney diseases, abdominal aortic aneurysm, connective tissue.
I
ntroduction
Abdominal aortic aneurysm (AAA) is a serious disease, with
significant morbidity andmortality.
1,2
The incidence of AAA
has been estimated to be 15-37 per 100,000 patients-year,
with an increased prevalence in bothmales and the elderly.
3
Due to the highmortality rate following AAA rupture, ultra-
sound screening has been recommended for high-risk pa-
tients aged 65-75 years.
4,5
Known risk factors for AAA devel-
opment include smoking, chronic obstructive pulmonary
disease, hypertension, atherosclerosis and familial history.
6,7
Recently, some publications suggested an association
between simple renal cysts (SRCs) and AAA.
8-10
Simple
renal cyst is the most common structural abnormality
observed in human kidneys, with prevalence ranging from
5-41%.
11,12
Similarly to what is seen with AAA, the preva-
lence of SRCs increases with age and in male population.
13
The majority of SRCs are asymptomatic, not harmful and
incidentally found by renal imaging, including comput-
ed tomography (CT) and ultrasonography. Most SRCs
are clinically irrelevant and seldom require treatment.
11,13
Some authors hypothesized that AAA and SRC might
share common pathophysiological mechanisms, includ-
ing possible manifestation of connective tissue weakness.
14
Furthermore, the association between SCRs and AAA