Evaluation of Renal Function of Angiomyolipoma Patients After Selective Transcatheter Arterial Embolization

被引:20
作者
Lee, Shen-Yang [2 ]
Hsu, Hsiang-Hao [2 ]
Chen, Yung-Chang [2 ]
Huang, Chen-Chih [1 ]
Wong, Yon-Cheong [1 ]
Wang, Li-Jen [1 ]
Chuang, Cheng-Keng [3 ]
Yang, Chih-Wei [2 ]
机构
[1] Chang Gung Univ, Coll Med, Chang Gung Mem Hosp, Dept Med Imaging & Intervent, Tao Yuan 33333, Taiwan
[2] Chang Gung Univ, Coll Med, Chang Gung Mem Hosp, Dept Nephrol, Tao Yuan 33333, Taiwan
[3] Chang Gung Univ, Coll Med, Chang Gung Mem Hosp, Dept Urol, Tao Yuan 33333, Taiwan
关键词
Angiomyolipoma; Chronic kidney disease; Transcatheter arterial embolization; Nephrectomy; Tuberous sclerosis complex; NEPHRON-SPARING SURGERY; MANAGEMENT; HEMORRHAGE; DIAGNOSIS; OUTCOMES; ADULTS;
D O I
10.1097/MAJ.0b013e31817f6dd9
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Angiomyolipoma patients may have renal insufficiency before selective transcatheter arterial embolization (TAE) or may undergo subsequent surgery after TAE. Therefore, this retrospective study examined our experience with TAE or TAE and subsequent surgery oil renal function of angiomyolipoma patients with and without preexisting renal insufficiency. Methods: 25 patients who had undergone TAE for renal angiomyolipoma over a 7-year period were reviewed. The 25 patients were grouped according to whether or not they had undergone further surgery. Preexisting renal insufficiency was compared between the 2 groups. The TAE and surgery group was further subdivided into 2 Subgroups according to total nephrectomy or not. The TAE-alone group was further subdivided into 2 subgroups by presence of preexisting renal insufficiency or not. In each group and subgroup, pre-TAE and post-TAE renal function, including serum creatinine and creatinine clearance were compared. Results: TAE rather than TAE and surgery was more likely chosen in the presence of preexisting renal insufficiency (6/13 versus 1/12, P = 0.035). In TAE-alone patients, no statistical differences were noted between serum creatinine and creatimne clearance before and after TAE. Conversely, TAE and surgery patients who had undergone total nephrectomy rather than nephron-sparing surgery differed significantly in preand post-TAE serum creatinine (0.77 versus 1.07, P = 0.014) and creatinine clearance (98.1 versus 70.7, P = 0.032). Conclusions: This study demonstrated that TAE alone for treating renal angiomyolipomas was able to preserve renal function, despite the presence of mild preexisting renal insufficiency. Conversely, surgery after TAE, particularly total nephrectomy, should be avoided whenever possible.
引用
收藏
页码:103 / 108
页数:6
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