Kidney Week

Abstract: TH-PO474

Long-Term Changes in Liver and Kidney Cyst Volumes following Foam Sclerotherapy

Session Information

• Cystic Kidney Diseases: Clinical Assessment and Therapeutic Directions
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Genetic Diseases of the Kidneys

• 1201 Genetic Diseases of the Kidneys: Cystic

Authors

• Howe, Cassie, Mayo Clinic Research Rochester, Rochester, Minnesota, United States

Cassie Howe

• Helland, Ryan, Mayo Clinic Research Rochester, Rochester, Minnesota, United States

Ryan Helland

• Vaughan, Lisa E., Mayo Quantitative Health Sciences, Rochester, Minnesota, United States

Lisa E. Vaughan, MS

• Kline, Timothy L., Mayo Clinic Research Rochester, Rochester, Minnesota, United States

Timothy L. Kline, MS, PhD

• Gregory, Adriana, Mayo Clinic Research Rochester, Rochester, Minnesota, United States

Adriana Gregory, MS

• Torres, Vicente E., Mayo Clinic Research Rochester, Rochester, Minnesota, United States

Vicente E. Torres, MD, PhD

• Hogan, Marie C., Mayo Clinic Research Rochester, Rochester, Minnesota, United States

Marie C. Hogan, MBChB, PhD, FASN

Group or Team Name

• Div of Nephrology, Mayo Clinic.

Background

This medical center uses sotradecol foam sclerotherapy (SFS) in managing symptomatic kidney/ liver cysts. Using ultrasound & fluoroscopy, kidney/ liver cysts (≥5cm; up to 4/session) are targeted for SFS. A drain is placed into the cyst, contrast injected, aspirated & sclerosant instilled (3% sodium tetradecyl sulfate). We have performed SFS in >200 individuals & evaluated durability in a subset of patients with longerm sequential imaging.

Methods

Cases from 1/2017-12/2021 with available TKCV /TLCV (per Targeted Kidney or Liver or Cyst analysis) and with long-term image follow up were segmented using a deep-learning algorithm and cyst segmentation software (pre, post procedure and last imaging). Median TKCV/ TLCV percent change per patient were evaluated using the 1-sample Wilcoxon signed rank test. Changes in liver and kidney cyst volumes over time were modeled using linear mixed effects regression methods with time modeled as a restricted cubic spline term.

Results

One hundred forty five SFS sessions were performed on 102 unique individuals (62 kidney, 74 liver, 9 combined liver/ kidney cysts). A total of n=78 kidney cysts in 34 patients and n=138 liver cysts in 46 patients with pre and post imaging within 6 mo prior to procedure & at least 2 mo post-procedure, respectively. Median [interquartile range, IQR] % reductions in TKCV were -92.0% [IQR-98.2%, -82.7%]; (p<0.001) & for TLCV -83.1% [IQR -93.5%, -52.9%]; (p <0.001). Among 12 patients with multiple follow-up images available (2 follow-up images for all patients), there were a total of 72 cysts (30 liver & 42 kidney cysts). Both liver & kidney cyst volumes sharply declined to near 0 around 1 year follow-up, and then remained relatively stable several years later (P<0.001 for non-linear associations for both liver & kidney cyst volumes using LRT test). Figure 1.

Conclusion

Foam sclerotherapy is durable and is an option for management of individuals with symptomatic large kidney and liver cysts.

Change in targeted kidney and liver cyst volumes over time.

Funding

• NIDDK Support