Ecder T, et al. Am J Kidney P5091 nmr Dis. 2000;35:427–32. (Level 2)   8. Schrier R, et al. J Am Soc Nephrol. 2002;13:1733–9. (Level 2)   9. Kanno

Y, et al. QJM. 1996;89:65–70. (Level 4)   10. Nutahara K, et al. Nephron Clin Pract. 2005;99:c18–23. (Level 2)   11. Mitobe M, et al. Clin Exp Nephrol. 2010;14:573–7. (Level 4)   12. Zeltner R, et al. Nephrol Dial Transplant. 2008;23:573–9. (Level 2)   13. Ecder T, et al. Am J Nephrol. 2001;21:98–103. (Level 3)   Does screening of intracranial aneurysms improve the prognosis in patients with ADPKD? The high incidence of intracranial aneurysms in patients with ADPKD has long been recognized. Rupture of an intracranial aneurysm resulting in subarachnoid hemorrhage (SAH) is the most devastating of SB-715992 mouse extrarenal complications, and often results in premature death or disability. The overall prevalence was estimated to be 3.2 % (95 % CI 1.9–5.2) in a population without comorbidity, with a mean age of 50 years, and a 50 % component of men. Compared with populations without comorbidity, the prevalence ratio was 6.9 (95 % CI 3.5–14) for SAR302503 mouse ADPKD. First-degree relatives (parents, siblings, and children) of patients with subarachnoid hemorrhage have a three to seven times higher risk of SAH than the general population. Size of the aneurysm

size correlates with the presence of symptoms and the risk of bleeding, and aneurysms may rupture more often and at a younger age as compared with sporadic aneurysms. Large aneurysms seem to occur more often in patients with ADPKD than in those without. Intracranial hemorrhage, either cerebral hemorrhage or aneurysmal SAH, can cause high mortality and morbidity in PKD patients. Screening of intracranial aneurysms improves the prognosis. If the result of screening by MR angiography is negative, rescreening of patients with a good life expectancy at 5-year intervals seems reasonable. Bibliography 1. Chauveau D, et al. Kidney Int. 1994;45:1140–6. (Level 4)   2. Schievink WI, et al. J Am Soc Nephrol. 1992;3:88–95. (Level 4)   3. Vlak MH, et al. Lancet Neurol. 2011;10:626–36. (Level 4)   4. Irazabal MV, et al. Monoiodotyrosine Clin J Am Soc Nephrol. 2011;6:1274–85.

(Level 4)   5. Xu HW, et al. Stroke. 2011;42:204–6. (Level 4)   6. Gieteling EW, et al. J Neurol. 2006;250:418–23. (Level 4)   7. Wiebers DO, et al. Lancet. 2003;362:103–10. (Level 4)   Are newer quinolones recommended for the treatment of cyst infection in ADPKD? Cyst infection is a frequent and serious complication of ADPKD and is often refractory and difficult to treat. Most causative bacteria originate from the intestine and many are gram-negative rods. Fluoroquinolones, which have broad effectiveness against gram-negative rods and good penetration into cysts, is recommended for the treatment of infected cysts in ADPKD. Having said this, however, there has not been an adequate level of study to investigate the actual effectiveness of fluoroquinolones for treating cyst infection in ADPKD.