The mass effect of nephromegaly in patients with autosomal dominant polycystic kidney disease may cause pain and symptoms by compressing the alimentary tract, lungs, and heart. Conventional therapies exist to contract enlarged polycystic kidneys including surgical and interventional procedures. A surgical nephrectomy is often difficult to perform in dialysis patients due to the associated risks related to surgery. In contrast, renal transcatheter arterial embolization (TAE) with metallic coils, which is a less invasive interventional procedure, can also be utilized to contract enlarged kidneys in dialysis patients as an effective treatment. However, metallic coils present the possibility of recanalization and cost issues. Thus, we used ethanol instead of coils in renal TAE to resolve these issues. We report a dialysis patient with enlarged polycystic kidneys and poor oral intake due to abdominal distention that was successfully treated by TAE with absolute ethanol.
Aged ; Contrast Media/administration & dosage ; Embolization, Therapeutic/*methods ; Ethanol/*therapeutic use ; Ethiodized Oil/administration & dosage ; Humans ; Male ; Polycystic Kidney, Autosomal Dominant/radiography/*therapy ; *Renal Dialysis ; Tomography, X-Ray Computed

OBJECTIVE: To evaluate the effects of cyst ablation with absolute ethanol in autosomal-dominant polycystic kidney disease (ADPKD) patients with symptomatic cysts. MATERIALS AND METHODS: Using absolute ethanol, cyst ablation was performed in 11 patients with documented ADPKD who suffered cyst pain refractory to medical treatment. An ethanol solution was instilled into the largest symptomatic cysts through a catheter. We assessed the therapeutic efficacy of the procedure by tracking subjective pain relief during a 3 to 24-month follow-up period after ablation. RESULTS: At follow-up, we found that the duration of subjective pain relief was 12 to 24 months in seven patients, 4 to11 months in one, and less than 3 months in three. CONCLUSION: Selective ablation of a symptomatic cyst may be a valid option in managing chronic pain caused by one or a few large cysts in ADPKD patients.
Adult ; Aged ; Contrast Media/administration & dosage ; Ethanol/*therapeutic use ; Female ; Follow-Up Studies ; Human ; Male ; Middle Aged ; Pain, Intractable/etiology/physiopathology/*therapy ; Palliative Care/methods ; Polycystic Kidney, Autosomal Dominant/physiopathology/radiography/*therapy ; Sclerotherapy/*methods ; Solvents/therapeutic use ; Tomography, X-Ray Computed ; Treatment Outcome