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Kidney Week

Abstract: FR-PO1037

Outcomes of Arterial Embolization in Treating Renal Angiomyolipomas: A Single Center Experience

Session Information

Category: Genetic Diseases of the Kidney

  • 1002 Genetic Diseases of the Kidney: Non-Cystic

Authors

  • Shariff, Saad Mohammed, University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Albalas, Alian, University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Almehmi, Ammar, University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Abdel Aal, Ahmed Kamel, University of Alabama at Birmingham, Birmingham, Alabama, United States
Background

Selective arterial embolization (SAE) of renal angiomyolipoma (AML) is associated with parenchymal loss and contrast exposure. The aim of this study was to evaluate the baseline characteristics and the change in glomerular filtration rate (GFR) in patients with AML following SAE.

Methods

This study included all AML cases that were treated with SAE procedure at our center from 2004 to 2017. Data on demographics, tumor size, and other laboratory values were collected. Serum creatinine and calculated GFR were assessed immediately prior and 3 months after SAE procedure. GFR was calculated using CKD-EPI formula.

Results

Our cohort included 44 patients who underwent SAE. The indications for SAE included back pain, hematuria and retroperitoneal hemorrhage. Baseline characteristics were: age (mean ± SD) 47± 16.5 years; 77% females; 68% whites; and 36% were hypertensive. Acute kidney injury (AKI) was encountered in 4 patients (9%) following the SAE procedure.
The (mean ± SD) serum creatinine increase from 0.97 ± 0.48 to 1.17 ± 0.88 mg/dl (p=0.008) after SAE procedure. The GFR dropped from 86.7 ± 25.8 to 79.7 ± 28.8 ml/min after procedure (p= 0.001). Post SAE GFR correlated with the tumor size (p= 0.047). Further, patients who developed AKI was found to have larger AML as compared to those with no AKI (16.8 vs 7 cm; p<0.0001).

Conclusion

Following the embolization of renal AML, there was a statistically significant decrease in GFR.
Further, tumor size was associated with post procedure GFR and AKI incidence.
Although the decrease in GFR could be in part attributed to the partial parenchymal loss and contrast exposure, its clinical significance is yet to be elucidated.

Baseline Characteristics and changes in GFR & Creatinine after AML Embolization
 Large (Tumor size 〉4cm)
N=40
Small (Tumor Size 〈4cm)
N=4
p-Value
Age Mean ± SD47.1 ± 16.746.3 ± 17.10.84
Female30 (75%)4 (100%)0.26
Race- White27 (67.5%)3 (75%)0.90
Hypertension16 (40%)0 (0%)0.11
Symptoms- Pain14 (35%)1 (25%)0.69
Symptoms- Hemorrhage26 (65%)3 (75%)0.69
Acute Kidney Injury4 (10%)0 (0%)0.51
 Pre-EmbolizationPost-Embolizationp-Value
Serum Creatinine, Mean(SD)0.97 (0.48)1.17(0.88)0.0080
GFR CKD Epi, Mean (SD)86.7 (25.8)79.7 (28.8)0.0019