Prevalence of Inferior Vena Cava Compression in Autosomal Dominant Polycystic Kidney Disease

Abstract Introduction Kidney and liver cysts in autosomal dominant polycystic kidney disease (ADPKD) can compress the inferior vena cava (IVC), but IVC compression prevalence and risk factors are unknown. Methods ADPKD patients (n=216) with abdominal MR studies and age/sex matched controls were evaluated for IVC compression as well as azygous vein diameter (a marker of collateral blood flow) and IVC aspect ratio (left-to-right dimension divided by anterior-to-posterior dimension with a value of 1 corresponding to a circular (high pressure) IVC caudal to compression. Results Severe IVC compression, ≥70%, was observed in 33(15%) ADPKD subjects and mild compression (≥50%to > 40 years had 12-fold higher risk of IVC compression (95%CI: 4.2-42.4), with highest predicted probability for Mayo Clinic class 1D (59% [95%CI: 39-76%]) and 1E (74% [95%CI: 49-90%]) after adjustment (p > 2000ml/m had 83% (95%CI:59%-95%) prevalence of IVC compression. Complications included deep vein thrombosis and symptomatic hypotension. Conclusion IVC compression is common in ADPKD patients > 40 years old, with Mayo Clinic class 1D/E, and in females with ht-LV>2000ml/m.