Presence of simple renal cysts is associated with increased risk of aortic dissection: a common manifestation of connective tissue degeneration?
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.


CONCLUSIONS
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.
Division of Cardiology, Department of Medicine, Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Eun Kyoung
EK
Kim
E Ryoung
ER
Choi
Bong Gun
BG
Song
Shin Yi
SY
Jang
Sung Min
SM
Ko
Seung-Hyuk
SH
Choi
Jidong
J
Sung
Kiick
K
Sung
Yeon Hyeon
YH
Choe
Jae K
JK
Oh
Duk-Kyung
DK
Kim
D017677:Age Distribution; D000368:Aged; D000784:Aortic Dissection / Q000209:etiology*; D001014:Aortic Aneurysm / Q000209:etiology*; D016022:Case-Control Studies; D003240:Connective Tissue Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D052177:Kidney Diseases, Cystic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors