The Japanese Journal of Clinical Dialysis Vol.23 No.1(2-8)

Theme Interventional Radiology for Dialysis Patients
Title ADPKD and IVR
Publish Date 2007/01
Author Yoshifumi Ubara Nephrology Center, Toranomon Hospital
Author Yoko Sogawa Nephrology Center, Toranomon Hospital
Author Tatsuya Suwabe Nephrology Center, Toranomon Hospital
Author Yasushi Higa Nephrology Center, Toranomon Hospital
Author Syohei Nakanishi Nephrology Center, Toranomon Hospital
Author Kenmei Takaichi Nephrology Center, Toranomon Hospital
[ Summary ] The kidneys of patients with autosomal dominant polycystic kidney disease (ADPKD) usually continue to increase in size even after patients begin dialysis, and mass effects may lead to severe complications. Since the kidneys of ADPKD patients are usually supplied by well developed arteries, we attempted renal contraction therapy in ADPKD patients with renal transcatheter arterial embolization (TAE) using intravascular coils. Primarily, peripheral branches of the renal arteries encircling the cysts were embolized. To this time, this treatment has been confirmed to be effective on 387 patients. Renal size continued to decrease to 53 % of the pre-TAE after one year. Improvements in quality of life and nutritional status has been obtained in almost all patients.
Based on our observation of ADPKD through treatment with TAE, we speculate that cyst growth in both the kidneies and the liver progresses via a mechanism of “arteriogenesis” of large vessels as well as “angiogenesis” of small vessels.
back