Cyst decompression surgery for autosomal dominant polycystic kidney disease

Lawrence W. Elzinga, John M. Barry, Vicente E. Torres, Horst Zincke, Heinz W. Wahner, Suzanne Swan, William M. Bennett

Research output: Contribution to journalArticle

75 Scopus citations

Abstract

A prospective study was undertaken to evaluate the efficacy of surgical cyst decompression for retarding the progression of renal failure and for the management of chronic pain associated with autosomal dominant polycystic kidney disease (ADPKD). Thirty patients with ADPKD and pain (14 patients), renal insufficiency (4 patients), or both (12 patients) underwent unilateral (19 patients) or bilateral (11 patients) cyst reduction surgery. The patients were monitored for 21 ± 2 months postoperatively. The probability of being painfree was 80% at 1 yr and 62% at 2 yr. Preoperative and 1- to 3-month postoperative serum creatinine levels and GFR (clearance of inulin or (125I) iothalamate) were not significantly different (2.2 ± 0.3 versus 2.2 ± 0.3 mg/dL and 49 ± 8 versus 54 ± 9 mL/min/1.73 m2, respectively). One-year serum creatinine levels remained unchanged in patients with normal preoperative renal function ( 1.0 ± 0.07 versus 1.0 ± 0.05 mg/dL), whereas those with preoperative progressive renal insufficiency had no difference in the mean slope of reciprocal serum creatinine plots preceding and after surgery (-0.008 ± 0.001 versus -0.009 ± 0.002 dL/mg/month). In patients who underwent unilateral surgery, split function isotope scans showed no change in function of the operated kidney when compared with the nonoperated kidney. Surgical cyst decompression provides effective relief of chronic pain without compromising renal function. However, the data in this article do not support the use of this procedure to slow progression of renal insufficiency in ADPKD.

Original languageEnglish (US)
Pages (from-to)1219-1226
Number of pages8
JournalJournal of the American Society of Nephrology
Volume2
Issue number7
StatePublished - Jan 1 1992

Keywords

  • Chronic renal disease
  • Cyst marsupialization
  • Cyst pain
  • Hereditary renal disease
  • Rovsing's procedure

ASJC Scopus subject areas

  • Nephrology

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  • Cite this

    Elzinga, L. W., Barry, J. M., Torres, V. E., Zincke, H., Wahner, H. W., Swan, S., & Bennett, W. M. (1992). Cyst decompression surgery for autosomal dominant polycystic kidney disease. Journal of the American Society of Nephrology, 2(7), 1219-1226.