TAE Effective for Polycystic Kidney and Liver

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					WCN coverage_0909     9/25/09    4:19 PM    Page 1

      30 Renal & Urology News                   OCTOBER 2009

       TAE Effective for Polycystic Kidney and Liver
      Transcatheter polycystic embolization was well-tolerated, and no deaths occurred as a result
      BY CAROLINE HELWICK                            using intravascular platinum micro-
      AN INTRAVASCULAR treatment                     coils as the embolization material,”
      for intractable symptomatic poly-              Dr. Suwabe said at the World Con-
      cystic kidney and liver due to auto-           gress of Nephrology’s annual meeting
      somal dominant polycystic kidney               in Milan, Italy.
      disease (ADPKD) is highly effec-                 Except for patients who died of
      tive, according to the findings of a           other causes, all patients undergoing
      Japanese study.                                renal TAE had a favorable clinical
        Tatsuya Suwabe, MD, of the                   course. Seventeen patients underwent
      Nephrology Center at Toranomon                 renal transplantation; 15 had nephrec-
      Hospital Kajigaya, Kanagawa, Japan,            tomy and two did not.
      reported the results from a series of            Of the 243 hepatic TAE patients,
                                                     202 had a favorable clinical course, but
                                                     improvement was not observed in
      TAE is generally                               41 patients with severe liver damage
      more effective for                             marked by massive ascites and cystic
                                                     infection, he reported.
      enlarged kidney                                  “TAE is generally more effective for
                                                     enlarged kidney than liver.…[the]
      than for the liver.                            average volume reduction [in the kid-
                                                     ney] exceeds 50%, compared with
      579 patients with enlarged polycys-            about 20% for the liver,” he said.
      tic kidney and 243 patients with en-             In one of the more dramatic exam-
      larged polycystic liver treated with           ples, a patient with liver-dominant
      trans-catheter arterial embolization           cysts achieved a reduction in total         Before renal-TAE                           After renal-TAE
      (TAE). Of the 579 patients with                hepatic volume from 9,659 cm3 to
      enlarged kidneys, 106 also had en-             3,225 cm3 and reduction in intra-             “Before hepatic TAE, there is a          explained. The procedure was well-
      larged livers.                                 hepatic cyst volume from 8,427 cm3 to       gradual growth of cysts. After TAE,        tolerated in both kidney-dominant or
        “Since kidney and liver in ADPKD             1,736 cm3. Reductions were main-            cysts become less tense and begin to       liver-dominant patients, though one
      patients are usually supplied by well-         tained for one year after TAE. Hepat-       shrink, and the decompressed paren-        patient with renal metastasis of
      developed arteries, we attempted to            ic parenchyma, however, increased,          chyma tends to expand in volume            bladder cancer died after renal TAE,
      contract the enlarged organs by TAE,           Dr. Suwabe reported.                        and return to its original position,” he   he noted. n

       First-Degree Relatives of CKD Patients Are at Higher CKD Risk
       BY CAROLINE HELWICK                              The researchers, who presented           screened for CKD, the study said.          uals with family history of CKD identi-
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