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Survival after arterial embolization therapy in patients with polycystic kidney and liver disease

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Abstract

Background

Transcatheter arterial embolization (TAE) has become a therapeutic option for symptomatic polycystic kidney disease (PKD) and polycystic liver disease (PLD). However, factors affecting survival with renal TAE remain unknown.

Methods

All symptomatic patients with severe PKD and/or PLD who received renal and/or hepatic TAE at our center from October 1996 through March 2013 (n = 1,028) were followed until death. Their survival was compared with that of the general PKD population on dialysis in Japan. Factors affecting survival were analyzed using the Cox hazard model.

Results

After renal TAE, 5- and 10-year survival was, respectively, 0.78 (95 % confidence interval, 0.74–0.82) and 0.56 (0.49–0.63); with hepatic TAE, 0.69 (0.58–0.77) and 0.41 (0.22–0.60); and with dual TAE (renal and hepatic), 0.82 (0.72–0.88) and 0.45 (0.31–0.59). Survival after dialysis initiation was better among patients with renal TAE than among general PKD patients. Factors affecting survival after renal TAE were age [hazard ratio (HR) 3.02 (1.44–6.33) for every 10 years] and albumin [HR 0.70 (0.55–0.89) per 0.1 g/dl]. Kidney volume was not associated with patient death after TAE. The main causes of death among patients after renal TAE were similar to those of the general PKD population on dialysis whereas, after hepatic TAE, the main cause was cyst infection with liver failure (12.5 % with PLD and 5.9 % with PKD, p < 0.01).

Conclusion

Survival after renal TAE with severe PKD was better than for the general PKD population on dialysis, suggesting that renal TAE could overcome the disadvantage due to huge organ size.

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Acknowledgments

This work was supported by JH’s research Grants from the Okinaka Memorial Institute, Toranomon Hospital, and The Kidney Foundation, Japan (JKFB13-9), by TS’s Grant from the Japanese Association of Dialysis Physicians (JADP Grant 2013-11), and by YU’s grant from the Okinaka Memorial Institute.

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Correspondence to Junichi Hoshino.

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40620_2014_138_MOESM1_ESM.docx

Supplementary Fig. 1: Overall survival after initiation of dialysis, age-matched analysis. Survival comparison with the general Japanese PKD population on dialysis of our age-matched patients on dialysis who received renal transcatheter arterial embolization (TAE), hepatic TAE, or dual TAE (sequential renal and hepatic TAE) (n = 285, mean age, 64.3 ± 4.9 years). Survival data of the general Japanese PKD population on dialysis is from the annual report (as of 31 December 2011) published by the Japanese Society for Dialysis Therapy (DOCX 103 kb)

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Hoshino, J., Suwabe, T., Hayami, N. et al. Survival after arterial embolization therapy in patients with polycystic kidney and liver disease. J Nephrol 28, 369–377 (2015). https://doi.org/10.1007/s40620-014-0138-0

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  • DOI: https://doi.org/10.1007/s40620-014-0138-0

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