Abstract: TH-PO475
Cell-Free and Concentrated Ascites Reinfusion Therapy Is More Effective for Refractory Ascites in Patients with Autosomal Dominant Polycystic Kidney Disease
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
- Kurihara, Shigekazu, Toranomon Byoin Bunin, Kawasaki, Kanagawa, Japan
- Suwabe, Tatsuya, Toranomon Byoin Bunin, Kawasaki, Kanagawa, Japan
- Yamanouchi, Masayuki, Toranomon Byoin Bunin, Kawasaki, Kanagawa, Japan
- Ubara, Yoshifumi, Toranomon Byoin Bunin, Kawasaki, Kanagawa, Japan
- Kamijo, Yuji, Shinshu Daigaku, Matsumoto, Nagano, Japan
- Sawa, Naoki, Toranomon Byoin Bunin, Kawasaki, Kanagawa, Japan
Background
Refractory ascites is one of frequent complications in patients with autosomal dominant polycystic kidney disease (ADPKD). Cell-free and Concentrated Ascites Reinfusion Therapy (CART) is known to be an effective treatment for refractory ascites. However, its efficacy in patients with ADPKD is unknown.
Methods
In this retrospective cohort study, we enrolled all patients (age > 18 years) with refractory ascites, who were treated with CART or simple abdominal paracentesis between January 2013 and December 2023 at the Toranomon Hospital Kajigaya in Japan. Patients who were diagnosed as liver or kidney cystic infection at the time of CART or paracentesis were excluded. Patients who underwent CART at least once were assigned in the CART group. Patients who had never undergone CART and underwent only paracentesis were assigned in the paracentesis group. We compared clinical characteristics and overall survival between the two groups, and analyzed factors associated with overall survival of the patients.
Results
A total of 42 patients underwent CART or paracentesis. 14 patients were excluded due to diagnosis of cyst infection. We enrolled 18 patients in the CART group (male 4; age 54.3±8.8 years, median observational periods 747 days) and 10 patients in the paracentesis group (3; 58.2±6.3 years, 568 days). There were no significant differences in clinical characteristics of the patients at baseline between two groups. 4 patients died in the CART group, while 6 patients died in the paracentesis group during the observation period. Kaplan-Meier survival curves indicated that patients in CART group had better overall survival(p=0.035). Univariable and multivariable cox proportional hazards regression analyses revealed CART and hemodialysis were significant factors associated with overall survival. The change in serum albumin level was +0.15 g/dL in the CART group and -0.10 g/dL in the paracentesis group (p=0.006). The patients in CART group had significantly more overall adverse events including mild adverse events such as transient fever; however, no serious adverse events were observed.
Conclusion
In patients with ADPKD accompanied by refractory ascites, CART improves overall survival without increasing serious complications compared to abdominal paracentesis.