{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T06:31:27Z","timestamp":1793341887858,"version":"4.5.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,30]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The 2025 KDIGO Clinical Practice Guideline for Autosomal Dominant Polycystic Kidney Disease (ADPKD) addresses intracranial aneurysms (ICAs) and other vascular manifestations, an aspect of ADPKD care which is of considerable clinical importance and associated with significant patient anxiety. This commentary from the ERA Working Group Genes &amp; Kidney provides a European perspective on guideline implementation, highlighting key areas requiring action and research. People with ADPKD face a 4\u20135-fold increased risk of ICA (prevalence \u223c12.9%) compared to the general population, yet absolute rupture rates remain low (0.57 per 1000 person-years). The guidelines appropriately emphasize risk-stratified, individualized approaches centered on family history, smoking history, and blood pressure control. Key points include the importance of patient information; selective screening in those with family history of ICA, subarachnoid hemorrhage, or unexplained sudden death; and use of contrast-free magnetic resonnance (MR) angiography as the preferred imaging modality. Rescreening intervals of 5\u201310 years are suggested for high-risk individuals with negative initial screening. Treatment decisions require multidisciplinary expertise at high-volume centers, balancing rupture risk against intervention complications. Thoracic aortic aneurysms show clear association with ADPKD, warranting family screening when present, while abdominal aortic aneurysms demonstrate no increased prevalence. Patient and clinician education emerges as paramount, moving beyond anxiety-driven approaches toward informed shared decision-making. Future research priorities include leveraging European registries to identify genetic risk modifiers, developing validated risk prediction tools, and establishing whether screening translates to improved clinical outcomes in ADPKD-specific populations.<\/jats:p>","DOI":"10.1093\/ndt\/gfag096","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:15:22Z","timestamp":1777637722000},"page":"2083-2090","source":"Crossref","is-referenced-by-count":4,"title":["KDIGO 2025 Clinical Practice Guideline for ADPKD: a commentary on intracranial aneurysms and other vascular manifestations from the ERA Working Group Genes &amp; Kidney"],"prefix":"10.1093","volume":"41","author":[{"given":"Melanie M Y","family":"Chan","sequence":"first","affiliation":[{"name":"Medical Research Council Laboratory of Medical Sciences, Imperial College London , London ,","place":["UK"]},{"name":"Imperial College Healthcare NHS Trust Department of Nephrology, , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4375-7236","authenticated-orcid":false,"given":"Tom","family":"Nijenhuis","sequence":"additional","affiliation":[{"name":"Research Institute for Medical Innovations and Radboudumc Center of Expertise for Rare Kidney Diseases, Radboud University Medical Center Department of Nephrology, , Nijmegen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Galletti","sequence":"additional","affiliation":[{"name":"PKD International , Geneva ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucile","family":"Figueres","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie et Immunologie Clinique, Centre de r\u00e9f\u00e9rence SORARE, Fili\u00e8re ORKID, Centre de r\u00e9f\u00e9rence Fili\u00e8re OSCAR , Nantes ,","place":["France"]},{"name":"Nantes Universit\u00e9, CHU Nantes, INSERM, Center for Research in Transplantation and Translational Immunology , UMR 1064, Nantes, F-44000 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4558-5236","authenticated-orcid":false,"given":"Maria Vanessa","family":"Perez\u00a0Gomez","sequence":"additional","affiliation":[{"name":"IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz UAM Department of Nephrology and Hypertension, , Madrid ,","place":["Spain"]},{"name":"RICORS2040 Department of Medicine, , Madrid ,","place":["Spain"]},{"name":"Departamento de Medicina, Facultad de Medicina, Universidad Aut\u00f3noma de Madrid , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1377-9880","authenticated-orcid":false,"given":"Jan","family":"Halbritter","sequence":"additional","affiliation":[{"name":"Charit\u00e9 Universit\u00e4tsmedizin Berlin Department of Nephrology and Medical Intensive Care, , Berlin ,","place":["Germany"]},{"name":"Renal Division, Faculty of Medicine, University Freiburg Medical Center, University of Freiburg , Freiburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6910-0745","authenticated-orcid":false,"given":"Roman-Ulrich","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital, University of Cologne Department II of Internal Medicine, , Cologne ,","place":["Germany"]},{"name":"Center for Rare Diseases Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne , Cologne ,","place":["Germany"]},{"name":"Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD) , Cologne ,","place":["Germany"]},{"name":"Medical Faculty, University Hospital D\u00fcsseldorf, Heinrich-Heine-University D\u00fcsseldorf Department of Nephrology, , D\u00fcsseldorf ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1958-4459","authenticated-orcid":false,"given":"Emilie","family":"Cornec-Le\u00a0Gall","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie, H\u00e9modialyse et Transplantation R\u00e9nale, Centre de r\u00e9f\u00e9rence MARHEA, Fili\u00e8re ORKID , CHRU Brest, Brest ,","place":["France"]},{"name":"University Brest , Inserm, UMR 1078, GGB, Brest ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"key":"2026103001473384200_bib1","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/j.kint.2024.07.009","article-title":"KDIGO 2025 Clinical Practice Guideline for the evaluation, management, and treatment of autosomal dominant polycystic kidney disease (ADPKD)","volume":"107","author":"Kidney Disease: Improving Global Outcomes (KDIGO) ADPKD Work Group","year":"2025","journal-title":"Kidney Int"},{"key":"2026103001473384200_bib2","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/j.kint.2024.07.010","article-title":"KDIGO 2025 clinical practice guideline for the evaluation, management, and treatment of autosomal dominant polycystic kidney disease (ADPKD): executive summary","volume":"107","author":"Torres","year":"2025","journal-title":"Kidney Int"},{"key":"2026103001473384200_bib3","article-title":"Du gros rein polykystique de l\u2019adulte [Internet]","author":"Lejars","year":"1888"},{"key":"2026103001473384200_bib4","doi-asserted-by":"publisher","first-page":"492","DOI":"10.34067\/KID.0000000000000331","article-title":"All patients with ADPKD should undergo screening for intracranial aneurysms: PRO","volume":"5","author":"Eswarappa","year":"2024","journal-title":"Kidney360"},{"key":"2026103001473384200_bib5","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.2215\/CJN.14691218","article-title":"Presymptomatic screening for intracranial aneurysms in patients with autosomal dominant polycystic kidney disease","volume":"14","author":"Sanchis","year":"2019","journal-title":"Clin J Am Soc Nephrol"},{"key":"2026103001473384200_bib6","doi-asserted-by":"publisher","first-page":"495","DOI":"10.34067\/KID.0000000000000322","article-title":"All patients with ADPKD should undergo screening for intracranial aneurysms: CON","volume":"5","author":"Chebib","year":"2024","journal-title":"Kidney360"},{"key":"2026103001473384200_bib7","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1016\/j.kint.2017.08.016","article-title":"Screening for intracranial aneurysms in autosomal dominant polycystic kidney disease is cost-effective","volume":"93","author":"Flahault","year":"2018","journal-title":"Kidney Int"},{"key":"2026103001473384200_bib8","doi-asserted-by":"publisher","first-page":"e0153176","DOI":"10.1371\/journal.pone.0153176","article-title":"Screening for unruptured intracranial aneurysms in autosomal dominant polycystic kidney disease: a survey of 420 nephrologists","volume":"11","author":"Flahault","year":"2016","journal-title":"PLoS One"},{"key":"2026103001473384200_bib9","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1053\/j.ajkd.2020.05.024","article-title":"Establishing a Core outcome set for autosomal dominant polycystic kidney disease: report of the standardized outcomes in nephrology-polycystic kidney disease (SONG-PKD) consensus workshop","volume":"77","author":"Cho","year":"2021","journal-title":"Am J Kidney Dis"},{"key":"2026103001473384200_bib10","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1016\/S1474-4422(11)70109-0","article-title":"Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis","volume":"10","author":"Vlak","year":"2011","journal-title":"Lancet Neurol"},{"key":"2026103001473384200_bib11","doi-asserted-by":"publisher","first-page":"2223","DOI":"10.1093\/ndt\/gfac027","article-title":"Diagnosis and risk factors for intracranial aneurysms in autosomal polycystic kidney disease: a cross-sectional study from the Genkyst cohort","volume":"37","author":"Lef\u00e8vre","year":"2022","journal-title":"Nephrol Dial Transplant"},{"key":"2026103001473384200_bib12","doi-asserted-by":"publisher","first-page":"2192","DOI":"10.1212\/WNL.0000000000003353","article-title":"Stable incidence but declining case-fatality rates of subarachnoid hemorrhage in a population","volume":"87","author":"Mackey","year":"2016","journal-title":"Neurology"},{"key":"2026103001473384200_bib13","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1001\/jamaneurol.2019.0006","article-title":"Worldwide incidence of aneurysmal subarachnoid hemorrhage according to region, time period, blood pressure, and smoking prevalence in the population: a systematic review and meta-analysis","volume":"76","author":"Etminan","year":"2019","journal-title":"JAMA Neurol"},{"key":"2026103001473384200_bib14","doi-asserted-by":"publisher","first-page":"sfaf253","DOI":"10.1093\/ckj\/sfaf253","article-title":"10 tips on how to take a proper family history in CKD patient care","volume":"18","author":"Cornec-Le\u00a0Gall","year":"2025","journal-title":"Clin Kidney J"},{"key":"2026103001473384200_bib15","doi-asserted-by":"publisher","first-page":"1274","DOI":"10.2215\/CJN.09731110","article-title":"Extended follow-up of unruptured intracranial aneurysms detected by presymptomatic screening in patients with autosomal dominant polycystic kidney disease","volume":"6","author":"Irazabal","year":"2011","journal-title":"Clin J Am Soc Nephrol"},{"key":"2026103001473384200_bib16","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1038\/s41588-020-00725-7","article-title":"Genome-wide association study of intracranial aneurysms identifies 17 risk loci and genetic overlap with clinical risk factors","volume":"52","author":"Bakker","year":"2020","journal-title":"Nat Genet"},{"key":"2026103001473384200_bib17","doi-asserted-by":"publisher","first-page":"1958","DOI":"10.1161\/STROKEAHA.108.539544","article-title":"Risk factors for aneurysmal subarachnoid hemorrhage in a prospective population study: the HUNT study in Norway","volume":"40","author":"Sandvei","year":"2009","journal-title":"Stroke"},{"key":"2026103001473384200_bib18","doi-asserted-by":"publisher","first-page":"9219","DOI":"10.1038\/s41598-019-45614-0","article-title":"Physical activity associates with subarachnoid hemorrhage risk- a population-based long-term cohort study","volume":"9","author":"Lindbohm","year":"2019","journal-title":"Sci Rep"},{"key":"2026103001473384200_bib19","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/j.jclinepi.2010.09.009","article-title":"Trade-off between benefit and harm is crucial in health screening recommendations. Part I: general principles","volume":"64","author":"Dans","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"2026103001473384200_bib20","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1159\/000513709","article-title":"Clinical factors associated with the risk of intracranial aneurysm rupture in autosomal dominant polycystic kidney disease","volume":"50","author":"Lee","year":"2021","journal-title":"Cerebrovasc Dis"},{"key":"2026103001473384200_bib21","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1001\/jamaneurol.2018.4165","article-title":"Procedural clinical complications, case-fatality risks, and risk factors in endovascular and neurosurgical treatment of unruptured intracranial aneurysms: a systematic review and meta-analysis","volume":"76","author":"Algra","year":"2019","journal-title":"JAMA Neurol"},{"key":"2026103001473384200_bib22","doi-asserted-by":"publisher","first-page":"290","DOI":"10.3174\/ajnr.A4490","article-title":"Autosomal dominant polycystic kidney disease and intracranial aneurysms: is there an increased risk of treatment?","volume":"37","author":"Rozenfeld","year":"2016","journal-title":"AJNR Am J Neuroradiol"},{"key":"2026103001473384200_bib23","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1038\/nrneph.2015.128","article-title":"Vascular complications in autosomal dominant polycystic kidney disease","volume":"11","author":"Perrone","year":"2015","journal-title":"Nat Rev Nephrol"},{"key":"2026103001473384200_bib24","doi-asserted-by":"publisher","first-page":"1671","DOI":"10.1212\/WNL.0b013e3181e04297","article-title":"Optimal screening strategy for familial intracranial aneurysms: a cost-effectiveness analysis","volume":"74","author":"Bor","year":"2010","journal-title":"Neurology"},{"key":"2026103001473384200_bib25","doi-asserted-by":"publisher","first-page":"LXXXI","DOI":"10.1177\/23969873221099736","article-title":"European Stroke Organisation (ESO) guidelines on management of unruptured intracranial aneurysms","volume":"7","author":"Etminan","year":"2022","journal-title":"Eur Stroke J"},{"key":"2026103001473384200_bib26","doi-asserted-by":"publisher","first-page":"2483","DOI":"10.1681\/ASN.V7112483","article-title":"Abdominal aortic aneurysms and autosomal dominant polycystic kidney disease","volume":"7","author":"Torra","year":"1996","journal-title":"J Am Soc Nephrol"},{"key":"2026103001473384200_bib27","doi-asserted-by":"publisher","first-page":"57594","DOI":"10.18632\/oncotarget.16338","article-title":"Risk of aortic aneurysm and dissection in patients with autosomal-dominant polycystic kidney disease: a nationwide population-based cohort study","volume":"8","author":"Sung","year":"2017","journal-title":"Oncotarget"},{"key":"2026103001473384200_bib28","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1016\/j.amjcard.2018.10.030","article-title":"Risk of Ascending Aortic Aneurysm in Patients With Autosomal Dominant Polycystic Kidney Disease","volume":"123","author":"Bouleti","year":"2019","journal-title":"Am J Cardiol"},{"key":"2026103001473384200_bib29","doi-asserted-by":"publisher","first-page":"107494","DOI":"10.1016\/j.vph.2025.107494","article-title":"Efficacy of beta-blocker agents on clinical outcomes in patients with thoracic aortic aneurysm: a systematic review and meta-analysis of randomized controlled trials","volume":"159","author":"Tanriverdi","year":"2025","journal-title":"Vasc Pharmacol"},{"key":"2026103001473384200_bib30","doi-asserted-by":"publisher","first-page":"e182","DOI":"10.1016\/j.jtcvs.2023.04.023","article-title":"2022 ACC\/AHA guideline for the diagnosis and management of aortic disease: a report of the American Heart Association\/American College of Cardiology Joint Committee on Clinical Practice Guidelines","volume":"166","author":"Isselbacher","year":"2023","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026103001473384200_bib31","doi-asserted-by":"publisher","first-page":"913","DOI":"10.1016\/j.ekir.2017.05.014","article-title":"Autosomal dominant polycystic kidney patients may be predisposed to various cardiomyopathies","volume":"2","author":"Chebib","year":"2017","journal-title":"Kidney In Rep"},{"key":"2026103001473384200_bib32","doi-asserted-by":"publisher","first-page":"150","DOI":"10.34067\/KID.0002942022","article-title":"Cardiac manifestations in patients with autosomal dominant polycystic kidney disease (ADPKD): a single-center study","volume":"4","author":"Arjune","year":"2023","journal-title":"Kidney360"}],"container-title":["Nephrology Dialysis Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ndt\/advance-article-pdf\/doi\/10.1093\/ndt\/gfag096\/68200490\/gfag096.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/41\/11\/2083\/68200490\/gfag096.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/41\/11\/2083\/68200490\/gfag096.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T05:47:38Z","timestamp":1793339258000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ndt\/article\/41\/11\/2083\/8666262"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,1]]},"references-count":32,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,5,1]]},"published-print":{"date-parts":[[2026,10,30]]}},"URL":"https:\/\/doi.org\/10.1093\/ndt\/gfag096","relation":{},"ISSN":["0931-0509","1460-2385"],"issn-type":[{"value":"0931-0509","type":"print"},{"value":"1460-2385","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,11]]},"published":{"date-parts":[[2026,5,1]]}}}