Infected hepatic and renal cysts: differential impact on outcome in autosomal dominant polycystic kidney disease.
BACKGROUND
Infected cysts are a frequent and serious complication of autosomal dominant polycystic kidney disease. Such infections are classified into those affecting hepatic cysts and those affecting renal cysts. The purpose of this study was to compare the clinical course of infected hepatic cysts with that of infected renal cysts in patients with autosomal dominant polycystic kidney disease.


METHODS
We analyzed 43 patients referred to us for additional treatment of severely infected cysts between January 2004 and December 2006. All patients who required further treatment in addition to antibiotic therapy were included.


RESULTS
Aspiration was performed in all 28 patients with infected hepatic cysts. As a result, 17 patients were cured, 4 remain under treatment, and 6 died. One patient was cured by partial hepatectomy. Among the 15 patients with renal cysts, aspiration was performed in 4 with identifiable infected cysts, while renal transcatheter arterial embolization after appropriate antibiotic therapy was performed in 11 without identifiable infected cysts. No patient developed recurrence.


CONCLUSIONS
In patients with infected renal cysts, aspiration or renal transcatheter arterial embolization after appropriate antibiotic therapy was effective. Although aspiration was often effective in patients with infected hepatic cysts, a good outcome was less likely than in those with renal cysts.
Suwabe
Tatsuya
T
Nephrology Center, Toranomon Hospital, Tokyo, Japan. suwabe@toranomon.gr.jp
Ubara
Yoshifumi
Y
Higa
Yasushi
Y
Nakanishi
Shohei
S
Sogawa
Yoko
Y
Nomura
Kazufumi
K
Nishimura
Hiroaki
H
Hoshino
Jyunichi
J
Sawa
Naoki
N
Katori
Hideyuki
H
Takemoto
Fumi
F
Nakamura
Michio
M
Tomikawa
Shinji
S
Hara
Shigeko
S
Takaichi
Kenmei
K
D000328:Adult; D000368:Aged; D003560:Cysts / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome