2016 Volume 49 Issue 7 Pages 469-474
【Background/Aim】Both total renal volume and the grade of renal dysfunction might influence the exacerbation of renal cyst infections associated with autosomal dominant polycystic kidney disease (ADPKD). However, the pathophysiological interaction between these two factors remains obscure. In this study, we compared the roles of the two factors on the resistance of renal cyst infections to antimicrobial therapy in ADPKD. 【Method】Of the 44 patients with ADPKD that were hospitalized at our institution between 2006 and 2011, the cases of patients with renal cyst infections were investigated retrospectively. On the basis of the guidelines for chronic kidney disease (CKD), we evaluated the stage of renal dysfunction and analyzed whether differences in renal volume affected treatment resistance within the same stage of renal dysfunction. 【Results】Of the 44 patients with ADPKD, we treated 14 patients for renal cyst infections, who were admitted a total of 24 times. In all of the patients with stage 3 or 4 CKD, antimicrobial therapy was effective against their renal cyst infections. In contrast, antimicrobial therapy was not effective (due to treatment resistance) in 7 of the 12 patients with stage 5 or 5D CKD, and two of them eventually died. In the 12 cases of stage 5/5D CKD, the mean expected renal volume of the 7 patients that exhibited treatment resistance was 3,550 cm3 , whereas that of the other 5 patients was significantly smaller (1,985 cm3, p=0.03). 【Conclusion】Regarding the effects of treatment on renal cyst infections associated with ADPKD, renal volume and the grade of renal dysfunction might have independent effects on prognosis.
