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Kidney Week

Abstract: PO1272

The Prognostic Factors of Cyst Infection due to ADPKD

Session Information

Category: Genetic Diseases of the Kidneys

  • 1001 Genetic Diseases of the Kidneys: Cystic

Authors

  • Mizuno, Hiroki, Toranomon Byoin Bunin, Kawasaki, Kanagawa, Japan
  • Hoshino, Junichi, Toranomon Byoin, Minato-ku, Tokyo, Japan
  • Ubara, Yoshifumi, Toranomon Byoin Bunin, Kawasaki, Kanagawa, Japan
Background

Renal or hepatic cyst infection is a complication of autosomal dominant polycystic kidney disease (ADPKD), which requires hospitalization and causes death. Cyst aspiration was the gold standard to diagnose this disease. Because of its invasiveness, several diagnostic criteria without using cyst aspiration have been proposed, but prognostic factors of cyst infection have not been analyzed in this setting.

Methods

Inclusion criteria of this retrospective cohort are ADPKD patients who were admitted in Toranomon hospital and Toranomon hospital Kajigaya between 2016 April and 2021 March, and who were diagnosed as cyst infection based on MRI findings, which we previously published. Primary composite endpoint was defined combination of death, septic shock, or hospitalization for more than four weeks, and secondary outcomes were defined by each outcome mentioned above. Logistic analysis was planned to assess the predictors of the outcomes.

Results

One hundred ninety patients were eligible to this study. The average age was 65.0±9.2 years old, 116 (61.1%) were female, and the average height-adjusted total liver volume (htTLV) was 3322±2286 mL per meter, and 164 (86.3%) had hemodialysis therapy. Composite outcome occurred in 109 (57.4%): 25 death, 36 shock, and 98 longer-hospital-stay. Multivariable logistic regression model after adjusted related variables showed that older age (odds ratio(OR) 1.10 (95% confidence interval: 1.10-2.54), p-value=0.02), male (OR 2.49(1.16-5.33), p-value=0.02), higher htTLV (OR 2.29 (1.39-3.77), p<0.01), lower mean blood pressure at admission (OR 0.735(0.5798-0.9319),p=0.01), larger size of infectious cyst (OR:1.42(1.06-1.91), p=0.02) were significantly associated with the composite outcome. Although the culture-positive case or higher white blood cell count were not significantly associated with the primary outcome, they were associated with septic shock due to cyst infection.

Conclusion

Baseline characteristics at admission were associated with the prognosis of cyst infection diagnosed by MRI-based criteria, which was similar to cyst infection diagnosed by cyst aspiration. Culture-positive case or higher white cell count were reported as risk factors requiring more invasive therapies that could lead to septic shock and need longer hospitalization in our study’s cohort.