Motasem Alkhayyat, MD1, Mohannad Abou Saleh, MD1, Mohammad Abureesh, MD2, Ashraf Almomani, MD1, Alaa Habash, MD1, Woan Kim, DO1, Farhan M. Qayyum, DO, MA3, Adrian Lindsey, MD4, Hassan Siddiki, MD1, Prabhleen Chahal, MD1; 1Cleveland Clinic Foundation, Cleveland, OH; 2Staten Island University Hospital, New York City, NY; 3Cleveland Clinic Foundation, Warrensville Heights, OH; 4University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH
Introduction: Few studies demonstrated increased risk of pancreatic cysts (PC) among patients with adult (autosomal dominant) polycystic kidney disease (APCKD), however, they were limited by sample size. Using a large multi-center database, we aimed to evaluate the epidemiology and risk of PC in APCKD patients in the United States and identify underlying associations. Methods: A multi-institutional database (Explorys Inc, Cleveland, OH, USA), an aggregate of electronic health record data from 26 major integrated US healthcare systems, was surveyed. A cohort of patients with a Systematized Nomenclature of Medicine—Clinical Terms (SNOMED-CT) diagnosis of APCKD who underwent magnetic resonance imaging (MRI), computed tomography (CT), and/or endoscopic ultrasound (EUS) between 2016 and 2020 was identified. Another cohort of individuals who had MRI, CT, EUS and/or ERCP was also selected as a control group. The prevalence rate was calculated and age-, gender- and race-based distributions were described. Associated conditions were also reported. Results: There was a total of 32,411,600 individuals in the database above the age of 18 years old (2016-2020) with 10,056,500 (31.03%) who had an MRI, CT, ERCP, and/or EUS. Baseline characteristics of patients with APCKD and control group are shown in Table 2. There were 130 cases of PC among APCKD patients with a prevalence rate of 1.51%, 2.14% in the database and amongst patients who had an MRI, CT, ERCP and/or EUS respectively. Within the APCKD cohort, patients were more likely to be elderly ( >65 years old) and Caucasian. When compared to patients without APCKD, patients with APCKD were more likely to have a history of PC [OR: 4.00; 95% CI: 3.36-4.76, P< 0.0001]. In regards to associated medical conditions, patients with APCKD who developed PC had a history of diabetes, end-stage renal disease (ESRD), and dialysis requirement. There was no significant difference among the different CKD stages.(Table 1) Discussion: This is the largest study to date to evaluate the risk of PC among APCKD patients. Compared to the general population, patients with a history of APCKD were significantly associated with the development of PC. More prospective studies are needed to validate these findings and further delineate types and natural history of the different cysts.
Disclosures: Motasem Alkhayyat indicated no relevant financial relationships. Mohannad Abou Saleh indicated no relevant financial relationships. Mohammad Abureesh indicated no relevant financial relationships. Ashraf Almomani indicated no relevant financial relationships. Alaa Habash indicated no relevant financial relationships. Woan Kim indicated no relevant financial relationships. Farhan Qayyum indicated no relevant financial relationships. Adrian Lindsey indicated no relevant financial relationships. Hassan Siddiki indicated no relevant financial relationships. Prabhleen Chahal indicated no relevant financial relationships.