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Kidney Week

Abstract: TH-PO401

The Effect of Trans-Arterial Embolization of Renal Artery for Autosomal Dominant Polycystic Kidney Disease on the Recurrence of Cyst Infection

Session Information

Category: Genetic Diseases of the Kidneys

  • 1101 Genetic Diseases of the Kidneys: Cystic

Author

  • Mizuno, Hiroki, Toranomon Byoin Bunin, Kawasaki, Kanagawa, Japan
Background

Trans-arterial embolization of the renal artery (RTAE) is one of the procedures which reduces the mass effect of the enlarged polycystic kidney due to ADPKD after the initiation of renal replacement therapies (RRTs). In contrast, cyst infection is one of the life-threatening complications of ADPKD, however, the effect of RATE on recurrence of cyst infection has not been reported yet.

Methods

A retrospective analysis was conducted to assess the risk factors of recurrence of cyst infection. Cyst infection was defined as the in-hospital episode of fever, abdominal pain, and positive results of any cultures (blood, urine, or cyst fluid) after excluding the differential diagnosis of cyst infection. Patients not receiving RRTs were excluded because RTAE was a treatment for the patients under receiving RRTs. Recurrence was defined as the second episode of cyst infection within three years after the first episode of cyst infection. Predictors were collected from medical charts. Survival analyses were planned to determine the risk factors of recurrence.

Results

Among 883 episodes from 305 patients who were clinically suspected of renal cyst infection, 45 patients were eligible for the recurrence group and 58 patients were eligible for the no recurrence group. Compared with the no recurrence group, the recurrence group had a higher rate of the past history of recurrence and liver cyst infection. There was no difference in treatment status and conditions at discharge between groups. Kaplan-Meire curves showed that five factors, including (1) MRI detected cyst Infection, (2) age over 70 years old, (3) negative history of RTAE, (4) positive culture of extended-spectrum of beta-lactamase-producing Gram-negative rods or Enterococcus faecium (ESBL/faecium group), and (5) negative result of cyst culture, were significantly more likely to recurrence. After adjusting related variables, Cox hazard proportionally analysis revealed that previous history of RTAE (HR 0.49(0.26-0.94),p=0.03), ESBL/faecium group (1.96 (1,01-3.80)p=0.05), the negative result of drainage group (HR 2.27 (1,06-4.84)) were significantly associated with recurrence of cyst infection.

Conclusion

In this retrospective cohort study, we found the negative history of RTAE, ESBL/faecium group, and negative results of cyst culture could be the risk factors for recurrence of cyst infections.