PURPOSE: Autosomal dominant polycystic kidney disease (ADPKD) is the most common of the inherited renal cystic disease characterized by the development of renal cysts and various extrarenal manifestations such as other organs' cysts, intracranial aneurysms, dolichoectasias, aortic root dilatation, aneurysms, mitral valve prolapse and abdominal wall hernias. ADPKD is a cause of end-stage renal failure and a common indication for dialysis or renal transplantation. The renal size of ADPKD sometimes continues to increase even after the initiation of dialytic therapy and the patients complain of abdominal distension, dyspnea and appetite loss. Transcatheter arterial embolization of renal artery (TAE-RA) is one of the most effective treatments to diminish the renal size and relieve the symptoms of advanced ADPKD. We conducted the study to clarify the trends of the spirometory of advanced ADPKD patients on hemodialysis and whether TAE-RA improve the their spirometories.
METHODS: We prospectively accumulate the data of spirometories of advanced ADPDK on hemodyalisis before and after TAE-RA, which performed from January 2006 to October 2007. Vital capacity (VC) and forced expiratory volume in the first second (FEV1) were measured pre and post TAE-RA and the ratio to predicted value (%VC and % FEV1) were compared.
RESULTS: 28 subjects (mean age was 56.5 years old, 17 males and 11 females) were reviewed. The spirometories were normal in the most of advanced ADPKD on dialysis. %VC was 95.9% (95% confidence interval, 90.1 to 101.6) and %FEV1 was 87.9% (95% confidence interval, 82.1 to 93.7). Post TAE-RA, %VC increased to 100.1% (the change was 4.2%, 95% confidence interval, 0.4 to 8.1; P=0.031) and %FEV1 rise to 92.5% (the change was 4.6%, 95% confidence interval, 0.6 to 8.4; P=0.024).
CONCLUSION: Post TAE-RA, %VC and %FEV1 of advanced ADPKD on hemodialysis slightly but significantly improved.
CLINICAL IMPLICATIONS: TAE-RA for the patients of ADPKD may relieve not only their symptoms but also improve their pulmonary functions.
DISCLOSURE: Shiho Yamakoshi, No Financial Disclosure Information; No Product/Research Disclosure Information