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Infección de quistes hepáticos en pacientes con EHDA: resultados

Charles Ronsin1, François Jouret2,3, Simon Ville1,4

  • 1Department of Nephrology and Immunology, Nantes University Hospital, Nantes, France.

Kidney international reports
|January 16, 2026
PubMed
Resumen

Las infecciones de quistes hepáticos en pacientes con enfermedad renal poliquística autosómica dominante (EHDA) a menudo recurren. Las duraciones más prolongadas del tratamiento antibiótico (≥28 días) reducen el riesgo de fracaso del tratamiento, recaída y recurrencia de estas infecciones graves.

Palabras clave:
enfermedad renal poliquística autosómica dominanteinfección de quistesquiste hepático

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Área de la Ciencia:

  • Nefrología
  • Enfermedades Infecciosas
  • Hepatología

Sus antecedentes:

  • La infección de quistes hepáticos es una complicación rara pero grave en la enfermedad renal poliquística autosómica dominante (EHDA).
  • Las estrategias óptimas de manejo para las infecciones de quistes hepáticos asociadas a la EHDA no están bien establecidas.
  • Este estudio investiga los resultados del tratamiento para las infecciones de quistes hepáticos en pacientes con EHDA.

Objetivo del estudio:

  • Analizar las estrategias de tratamiento y los resultados de las infecciones de quistes hepáticos en pacientes con EHDA.
  • Identificar los factores que influyen en el fracaso del tratamiento, la recaída y la recurrencia de las infecciones de quistes hepáticos.
  • Proporcionar recomendaciones basadas en evidencia para el manejo de las infecciones de quistes hepáticos en la EHDA.

Principales métodos:

  • Estudio retrospectivo multicéntrico que incluyó a 62 pacientes y 112 episodios de infección de quistes hepáticos.
  • Infección definida por criterios clínicos, de laboratorio (CRP ≥ 50 mg/l) y de imagen (TC, 18FDG-PET/TC, RM), o confirmada por punción de quiste.
  • Análisis de los determinantes del fracaso del tratamiento, la recaída (<2 meses) y la recurrencia (>2 meses).

Principales resultados:

  • Escherichia coli fue el patógeno más común (51%), con una resistencia antimicrobiana significativa.
  • El fracaso del tratamiento o la recaída ocurrieron en el 27% de los episodios; una duración más prolongada de los antibióticos (≥14 días) fue protectora.
  • La recurrencia afectó al 38% de los pacientes; la duración de los antibióticos (≥28 días) y los antecedentes de infección de quistes renales fueron factores clave.

Conclusiones:

  • El manejo de la infección de quistes hepáticos requiere una cuidadosa consideración de la duración de los antibióticos.
  • La terapia antibiótica durante ≥28 días se asocia con una reducción del fracaso del tratamiento, la recaída y la recurrencia.
  • Los antecedentes de infección de quistes renales aumentan el riesgo de recurrencia, lo que requiere un seguimiento vigilante.