title: Survival after arterial embolization therapy in patients with polycystic kidney and liver disease.
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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Nephrology Center, Toranomon Hospital, 1-3-1, Kajigaya, Takatsu-ku, Kawasaki, Kanagawa, 213-8587, Japan, hoshino@toranomon.gr.jp.
authors.forename: Junichi
authors.initials: J
authors.lastname: Hoshino
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Suwabe
authors.forename: Noriko
authors.initials: N
authors.lastname: Hayami
authors.forename: Keiichi
authors.initials: K
authors.lastname: Sumida
authors.forename: Koki
authors.initials: K
authors.lastname: Mise
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kawada
authors.forename: Aya
authors.initials: A
authors.lastname: Imafuku
authors.forename: Rikako
authors.initials: R
authors.lastname: Hiramatsu
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yamanouchi
authors.forename: Eiko
authors.initials: E
authors.lastname: Hasegawa
authors.forename: Naoki
authors.initials: N
authors.lastname: Sawa
authors.forename: Ryoji
authors.initials: R
authors.lastname: Takei
authors.forename: Kenmei
authors.initials: K
authors.lastname: Takaichi
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Ubara
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003560:Cysts / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008107:Liver Diseases / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D016891:Polycystic Kidney, Autosomal Dominant / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016016:Proportional Hazards Models; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome