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Renal artery embolization for the symptomatic treatment of adult polycystic kidney disease

Nature Clinical Practice Nephrology volume 4, pages 236–237 (2008)Cite this article

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary disease of the kidneys worldwide. Although inevitable and progressive loss of kidney function is certainly the most life-threatening manifestation of ADPKD, there are a number of other troublesome symptoms associated with the disease, including abdominal pain, early satiety, abdominal distention, respiratory compromise, recurrent infections, hematuria, and hypertension. It is for the treatment of these 'mass effect' symptoms that renal artery embolization (RAE) holds promise. The procedure involves inducing thrombosis of the feeding arterioles by the use of Gelfoam® (Pfizer, New York, NY), local injections of alcohol, coils, or a combination of these approaches.

The first reported use of RAE in the management of polycystic kidneys was by Harley et al. in 1980 for the control of recurrent hemorrhage.1 Since that time, the vast majority of reported RAE procedures for ADPKD have been performed in Japan by Ubara and colleagues. In a recent paper, Ubara has reported the results of 266 such procedures.2 The data indicate the success of RAE, particularly with regard to producing a decrease in the size of the kidneys. CT scans showed an early decrease in kidney size to 73.8% of the original size (at 3 months), and a sustained decrease to 53.4% of the original size (at 1 year). Patients lost an average of 3.2 kg of body weight during the first 6 months after the procedure, but regained 0.6 kg of this lost weight within the subsequent 6 months, hypothetically because of an increased appetite.

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Authors and Affiliations

  1. MS Bremmer is a Medical Student and SC Jacobs is a Professor of Urology at the University of Maryland School of Medicine, Baltimore, MD, USA.,

    Matthew S Bremmer & Stephen C Jacobs

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  1. Matthew S Bremmer
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  2. Stephen C Jacobs
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Correspondence to Matthew S Bremmer.

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Bremmer, M., Jacobs, S. Renal artery embolization for the symptomatic treatment of adult polycystic kidney disease. Nat Rev Nephrol 4, 236–237 (2008). https://doi.org/10.1038/ncpneph0779

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