title: Can adequate treatment influence the postembolization syndrome and cytokine release in patients undergoing iatrogenic renal artery embolization?
abstract: The complete renal artery embolization is an alternative to surgical           nephrectomy in seriously ill patients. Iatrogenic embolization can be used in           many different conditions. Refractory nephrotic syndrome represents a very rare           indication for embolization. Complete renal artery embolization has usually been           complicated by postembolization syndrome (PES) which is characterized by flank           pain and fever. Possible immunologic contribution to the PES leads some authors           to the administration of corticosteroids to the patients undergoing embolization.           We report here a cohort of 13 patients undergoing complete embolization of total           21 kidneys due to refractory nephrotic syndrome non-responding to the various           specific treatment regimes. We treated our patients undergoing renal artery           embolization according to special protocol containing combination of antibiotic           drugs and corticosteroids (CS) to diminish PES and evaluated its influence to           the cytokine production. The incidence of PES was less frequent and milder in           comparison with the historical group of patients. Significant decrease in plasma           levels of tumor necrosis factor α during first post-embolization day (8.37 pre- vs.           5.74 pg/ml post-embolization, P=0.0002) could partially explain the reduction of           PES symptoms. The procedure was not complicated by severe complications and           represents an elegant alternative to surgical procedure. The accurate timing of the           embolization remains a controversial point in this intervention.
authors.affiliation: Department of Nephrology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic. rysavar@vfn.cz
authors.forename: R
authors.initials: R
authors.lastname: Ryšavá
authors.forename: Z
authors.initials: Z
authors.lastname: Hrušková
authors.forename: V
authors.initials: V
authors.lastname: Tesař
authors.forename: J
authors.initials: J
authors.lastname: Křivánek
authors.forename: M
authors.initials: M
authors.lastname: Haluzík
authors.forename: M
authors.initials: M
authors.lastname: Merta
authors.forename: L
authors.initials: L
authors.lastname: Vítek
mesh_terms: D000328:Adult; D016207:Cytokines / Q000097:blood*; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000401:mortality / Q000628:therapy*; D010166:Palliative Care; D012077:Renal Artery; D055815:Young Adult
chemical_list: D016207:Cytokines; D005938:Glucocorticoids