title: Radiologic and clinical bronchiectasis associated with autosomal dominant polycystic kidney disease.
abstract: BACKGROUND
  Polycystin 1 and 2, the protein abnormalities associated with autosomal dominant polycystic kidney disease (ADPKD), are also found in airway cilia and smooth muscle cells. There is evidence of increased radiologic bronchiectasis associated with ADPKD, though the clinical and functional implications of this association are unknown. We hypothesized an increased prevalence of both radiologic and clinical bronchiectasis is associated with APDKD as compared to non-ADPKD chronic kidney disease (CKD) controls.
  
  
  METHODS
  A retrospective case-control study was performed at our institution involving consecutive ADPKD and non-ADPKD chronic kidney disease (CKD) patients seen over a 13 year period with both chest CT and PFT. CTs were independently reviewed by two blinded thoracic radiologists. Manually collected clinical data included symptoms, smoker status, transplant history, and PFT findings.
  
  
  RESULTS
  Ninety-two ADPKD and 95 non-ADPKD CKD control patients were compared. Increased prevalence of radiologic bronchiectasis, predominantly mild lower lobe disease, was found in ADPKD patients compared to CKD control (19 vs. 9%, P = 0.032, OR 2.49 (CI 1.1-5.8)). After adjustment for covariates, ADPKD was associated with increased risk of radiologic bronchiectasis (OR 2.78 (CI 1.16-7.12)). Symptomatic bronchiectasis occurred in approximately a third of ADPKD patients with radiologic disease. Smoking was associated with increased radiologic bronchiectasis in ADPKD patients (OR 3.59, CI 1.23-12.1).
  
  
  CONCLUSIONS
  Radiological bronchiectasis is increased in patients with ADPKD particularly those with smoking history as compared to non-ADPKD CKD controls. A third of such patients have symptomatic disease. Bronchiectasis should be considered in the differential in ADPKD patients with respiratory symptoms and smoking history.
authors.affiliation: Division of Pulmonary/Critical Care, Mayo Clinic Rochester, Rochester, Minnesota, United States of America.
authors.forename: Teng
authors.initials: T
authors.lastname: Moua
authors.affiliation: Division of Nephrology, Mayo Clinic Rochester, Rochester, Minnesota, United States of America.
authors.forename: Ladan
authors.initials: L
authors.lastname: Zand
authors.affiliation: Department of Radiology, Mayo Clinic Rochester, Rochester, Minnesota, United States of America.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Hartman
authors.affiliation: Department of Radiology, Mayo Clinic Rochester, Rochester, Minnesota, United States of America.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Hartman
authors.affiliation: Division of Nephrology, Mayo Clinic Rochester, Rochester, Minnesota, United States of America.
authors.forename: Dingxin
authors.initials: D
authors.lastname: Qin
authors.affiliation: Division of Pulmonary/Critical Care, Mayo Clinic Rochester, Rochester, Minnesota, United States of America.
authors.forename: Tobias
authors.initials: T
authors.lastname: Peikert
authors.affiliation: Division of Nephrology, Mayo Clinic Rochester, Rochester, Minnesota, United States of America.
authors.forename: Qi
authors.initials: Q
authors.lastname: Qian
mesh_terms: D001987:Bronchiectasis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications*; D012044:Regression Analysis; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
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