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Cyst infections in patients with autosomal dominant polycystic kidney disease

Marion Sallée1, Cédric Rafat, Jean-Ralph Zahar

  • 1Department of Nephrology, Hôpital Necker, Paris, France.

Clinical Journal of the American Society of Nephrology : CJASN
|May 28, 2009
PubMed

Insights

Diagnosing and treating cyst infections in autosomal dominant polycystic kidney disease (ADPKD) is challenging. Positron emission tomography (PET) scans improve diagnosis, while combination antibiotics and drainage of large cysts are key treatments.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Radiology

Background:

  • Cyst infection presents diagnostic and therapeutic challenges in autosomal dominant polycystic kidney disease (ADPKD).
  • Published data on diagnosing and managing ADPKD cyst infections are limited.

Purpose of the Study:

  • To evaluate diagnostic methods and treatment strategies for cyst infections in ADPKD patients.
  • To analyze the incidence, microbiology, and outcomes of cyst infections in a cohort of ADPKD patients.

Main Methods:

  • Retrospective study of ADPKD patients with suspected renal/hepatic cyst infection at a referral center (Paris, France).
  • Inclusion of patients admitted between January 1998 and August 2008.
  • Review of medical files and analysis of diagnostic imaging (ultrasound, CT, MRI, PET) and treatment outcomes.

Main Results:

  • 33 out of 389 ADPKD patients (8.4%) experienced 41 cyst infection episodes.
  • Escherichia coli was the predominant pathogen (74% of documented cases).
  • Positron emission tomography (PET) scan demonstrated superior diagnostic accuracy compared to other imaging modalities. Initial antibiotic therapy was effective in 71% of cases, with combination therapy showing better outcomes than monotherapy. Large cysts (>5 cm) often required drainage.

Conclusions:

  • PET scans are likely to enhance the accuracy and ease of diagnosing ADPKD cyst infections.
  • Combined antibiotic therapy, particularly with a fluoroquinolone, and drainage of large cysts are the primary treatment approaches for ADPKD cyst infections.
Abstract

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