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Factors Influencing Cyst Infection in Autosomal Dominant Polycystic Kidney Disease

Tatsuya Suwabe1, Yoshifumi Ubara2,3, Noriko Hayami2

  • 1Department of Nephrology, Toranomon Hospital, Tokyo, Japan, suwabe@toranomon.gr.jp.

Nephron
|December 5, 2018
PubMed

Insights

Hepatomegaly significantly increases the risk of death and prolonged hospitalization in patients with autosomal dominant polycystic kidney disease (ADPKD) cyst infections. Early identification and management of enlarged liver are crucial for better patient outcomes.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Hepatology

Background:

  • Autosomal dominant polycystic kidney disease (ADPKD) frequently involves cyst infections, a serious complication often resistant to treatment.
  • Factors influencing the prognosis of ADPKD cyst infections remain poorly understood.
  • This study aimed to identify clinical factors associated with hospitalization duration and mortality in ADPKD patients with cyst infections.

Purpose of the Study:

  • To investigate clinical factors influencing hospitalization duration and death in autosomal dominant polycystic kidney disease (ADPKD) patients with cyst infections.
  • To identify predictors of mortality and prolonged hospital stay in this patient cohort.

Main Methods:

  • Retrospective review of 243 ADPKD patients with confirmed cyst infections (bacteria or neutrophils in cyst fluid) from January 2004 to March 2016.
  • Analysis of clinical data including hepatomegaly, white blood cell (WBC) count, culture results, and patient demographics.
  • Multivariate logistic and Cox proportional hazards regression models were used to assess factors associated with death and hospital stay duration.

Main Results:

  • Hepatomegaly, positive cyst culture, and elevated maximum WBC count were significantly associated with death from cyst infection.
  • Massive hepatomegaly (≥5,113.2 mL) dramatically increased the odds of death (OR 38.1).
  • Factors associated with longer hospital stays included older age, dialysis duration, hepatic transcatheter arterial embolization, maximum WBC count, and hepatomegaly. Female sex, nephrectomy, and improved serum markers were linked to shorter stays.

Conclusions:

  • Hepatomegaly is a critical factor strongly associated with both mortality and extended hospitalization in ADPKD patients experiencing cyst infections.
  • The size of hepatomegaly is a significant predictor, with massive enlargement correlating with increased death risk and prolonged hospital stays.
Abstract

Keywords:
Autosomal dominant polycystic kidney diseaseCyst infectionInfected cystPolycystic kidney disease

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