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Transcatheter renal artery embolization improves lung function in patients with autosomal dominant polycystic kidney disease on hemodialysis

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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.

Patients and 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 (%FEV1.0)] was done by spirometry in 28 patients on maintenance hemodialysis who had respiratory symptoms.

Results

Renal volume was 6,330.5 ± 3,126.5 cm3 (range 1,771–12,761 cm3) before TAE, and decreased significantly to 2,892.2 ± 1,841.7 cm3 (range 622–6,961 cm3) 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). %FEV1.0 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 FEV1.0 (ΔFEV1.0%) both showed a significant positive correlation with the reduction of renal volume (Δ renal volume) (p = 0.001 and p = 0.004, respectively).

Conclusion

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 %FEV1.0), pulmonary dysfunction should be recognized as one of the extrarenal complications of ADPKD.

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Acknowledgments

This study was funded by the Okinaka Memorial Institute for Medical Research.

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Authors and Affiliations

  1. Department of Pulmonary and Critical Care Medicine, Toranomon Hospital, Kajigaya, Kanagawa, Japan

    Shiho Yamakoshi & Masateru Kawabata

  2. Nephrology Center, Toranomon Hospital, Kajigaya, Kanagawa, Japan

    Shiho Yamakoshi, Yoshifumi Ubara, Tatsuya Suwabe, Rikako Hiramatsu, Masayuki Yamanouchi, Noriko Hayami, Keiichi Sumida, Eiko Hasegawa, Junichi Hoshino, Naoki Sawa & Kennmei Takaichi

  3. Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan

    Yoshifumi Ubara & Kennmei Takaichi

Authors
  1. Shiho Yamakoshi
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  2. Yoshifumi Ubara
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  3. Tatsuya Suwabe
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  4. Rikako Hiramatsu
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  7. Keiichi Sumida
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  9. Junichi Hoshino
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  10. Naoki Sawa
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  11. Kennmei Takaichi
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  12. Masateru Kawabata
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Corresponding author

Correspondence to Yoshifumi Ubara.

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Yamakoshi, S., Ubara, Y., Suwabe, T. et al. Transcatheter renal artery embolization improves lung function in patients with autosomal dominant polycystic kidney disease on hemodialysis. Clin Exp Nephrol 16, 773–778 (2012). https://doi.org/10.1007/s10157-012-0619-1

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  • DOI: https://doi.org/10.1007/s10157-012-0619-1

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