Evaluation of renal function of angiomyolipoma patients after selective transcatheter arterial embolization.
BACKGROUND
Angiomyolipoma patients may have renal insufficiency before selective transcatheter arterial embolization (TAE) or may undergo subsequent surgery after TAE. Therefore, this retrospective study examined our experience with TAE or TAE and subsequent surgery on renal function of angiomyolipoma patients with and without preexisting renal insufficiency.


METHODS
25 patients who had undergone TAE for renal angiomyolipoma over a 7-year period were reviewed. The 25 patients were grouped according to whether or not they had undergone further surgery. Preexisting renal insufficiency was compared between the 2 groups. The TAE and surgery group was further subdivided into 2 subgroups according to total nephrectomy or not. The TAE-alone group was further subdivided into 2 subgroups by presence of preexisting renal insufficiency or not. In each group and subgroup, pre-TAE and post-TAE renal function, including serum creatinine and creatinine clearance were compared.


RESULTS
TAE rather than TAE and surgery was more likely chosen in the presence of preexisting renal insufficiency (6/13 versus 1/12, P=0.035). In TAE-alone patients, no statistical differences were noted between serum creatinine and creatinine clearance before and after TAE. Conversely, TAE and surgery patients who had undergone total nephrectomy rather than nephron-sparing surgery differed significantly in preand post-TAE serum creatinine (0.77 versus 1.07, P=0.014) and creatinine clearance (98.1 versus 70.7, P=0.032).


CONCLUSIONS
This study demonstrated that TAE alone for treating renal angiomyolipomas was able to preserve renal function, despite the presence of mild preexisting renal insufficiency. Conversely, surgery after TAE, particularly total nephrectomy, should be avoided whenever possible.
Lee
Shen-Yang
SY
Department of Nephrology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Hsu
Hsiang-Hao
HH
Chen
Yung-Chang
YC
Huang
Chen-Chih
CC
Wong
Yon-Cheong
YC
Wang
Li-Jen
LJ
Chuang
Cheng-Keng
CK
Yang
Chih-Wei
CW
D000328:Adult; D000368:Aged; D018207:Angiomyolipoma / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D003404:Creatinine / Q000097:blood; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D007680:Kidney Neoplasms / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000209:etiology* / Q000503:physiopathology*; D012189:Retrospective Studies
D003404:Creatinine