title: Transcatheter renal artery embolization improves lung function in patients with autosomal dominant polycystic kidney disease on hemodialysis.
abstract: BACKGROUND
  Since 1996, transcatheter renal artery embolization (renal TAE) has been performed to reduce the volume of the kidneys in patients with autosomal dominant polycystic kidney disease (ADPKD) and complications of nephromegaly at our hospital. Respiratory dysfunction is often a serious problem in these patients before TAE.
  
  
  METHODS
  Between January 2006 and October 2008, renal TAE was performed and lung function testing [percent vital capacity (%VC) and percent forced expiratory volume in 1 s (%FEV(1.0))] was done by spirometry in 28 patients on maintenance hemodialysis who had respiratory symptoms.
  
  
  RESULTS
  Renal volume was 6,330.5 ± 3,126.5 cm(3) (range 1,771-12,761 cm(3)) before TAE, and decreased significantly to 2,892.2 ± 1,841.7 cm(3) (range 622-6,961 cm(3)) by 12 months after TAE (p = 0.0001). The percent decrease of renal volume at 12 months after TAE versus baseline was 45.6 ± 14.6% (range 6.6-67.3%). %VC showed a significant increase from 95.9 ± 14.8% (range 63-127%) before renal TAE to 100.1 ± 11.7% (range 78-120%) at 12 months after TAE (p < 0.01). %FEV(1.0) was also significantly increased from 87.9 ± 15.0% (range 55-110%) before renal TAE to 92.5 ± 14.4% (range 58.0-115.0%) at 12 months after TAE (p < 0.01). The changes of VC (ΔVC%) and FEV(1.0) (ΔFEV(1.0)%) both showed a significant positive correlation with the reduction of renal volume (Δ renal volume) (p = 0.001 and p = 0.004, respectively).
  
  
  CONCLUSIONS
  Since TAE not only led to a significant decrease of renal volume in ADPKD patients with nephromegaly, but also improved lung function (both %VC and %FEV(1.0)), pulmonary dysfunction should be recognized as one of the extrarenal complications of ADPKD.
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Toranomon Hospital, Kajigaya, Kanagawa, Japan.
authors.forename: Shiho
authors.initials: S
authors.lastname: Yamakoshi
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Ubara
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Suwabe
authors.forename: Rikako
authors.initials: R
authors.lastname: Hiramatsu
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yamanouchi
authors.forename: Noriko
authors.initials: N
authors.lastname: Hayami
authors.forename: Keiichi
authors.initials: K
authors.lastname: Sumida
authors.forename: Eiko
authors.initials: E
authors.lastname: Hasegawa
authors.forename: Junichi
authors.initials: J
authors.lastname: Hoshino
authors.forename: Naoki
authors.initials: N
authors.lastname: Sawa
authors.forename: Kennmei
authors.initials: K
authors.lastname: Takaichi
authors.forename: Masateru
authors.initials: M
authors.lastname: Kawabata
mesh_terms: D000328:Adult; D000368:Aged; D002404:Catheterization; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology*; D008171:Lung Diseases / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications* / Q000628:therapy; D012077:Renal Artery; D006435:Renal Dialysis; D012129:Respiratory Function Tests; D016896:Treatment Outcome