Background: Infected cysts are a frequent and serious complication of autosomal dominant polycystic kidney disease. Such infections are classified into those affecting hepatic cysts and those affecting renal cysts. The purpose of this study was to compare the clinical course of infected hepatic cysts with that of infected renal cysts in patients with autosomal dominant polycystic kidney disease. Methods: We analyzed 43 patients referred to us for additional treatment of severely infected cysts between January 2004 and December 2006. All patients who required further treatment in addition to antibiotic therapy were included. Results: Aspiration was performed in all 28 patients with infected hepatic cysts. As a result, 17 patients were cured, 4 remain under treatment, and 6 died. One patient was cured by partial hepatectomy. Among the 15 patients with renal cysts, aspiration was performed in 4 with identifiable infected cysts, while renal transcatheter arterial embolization after appropriate antibiotic therapy was performed in 11 without identifiable infected cysts. No patient developed recurrence. Conclusion: In patients with infected renal cysts, aspiration or renal transcatheter arterial embolization after appropriate antibiotic therapy was effective. Although aspiration was often effective in patients with infected hepatic cysts, a good outcome was less likely than in those with renal cysts.

1.
Torres VE: Polycystic kidney disease autosomal-dominant and recessive forms; in Massry SG, Glassock RJ (eds): Textbook of Nephrology, ed 4. Philadelphia, Lippincott Williams and Wilkins, 2001, pp 896–904.
2.
Chan KW: Adult polycystic kidney disease in Hong Kong Chinese. An autopsy study. Pathology 1993;25:229–232.
3.
Davies F, Coles GA, Harper PS, Williams AJ, Evans C, Cochlin D: Polycystic kidney disease re-evaluated: a population-based study. Q J Med 1991;79:477–485.
4.
Higashihara E, Nutahara K, Kojima M, et al: Prevalence and renal prognosis of diagnosed autosomal dominant polycystic kidney disease in Japan. Nephron 1998;80:421–427.
5.
Ubara T, Tagami T, Sawa N, et al: Renal contraction therapy for enlarged polycystic kidneys by transcatheter arterial embolization in hemodialysis patients. Am J Kidney Dis 2002;39:571–579.
6.
Ubara Y, Takei R, Hoshino J, et al: Intravascular embolization therapy in a patient with an enlarged polycystic liver. Am J Kidney Dis 2004;43:733–738.
7.
Ubara Y: New therapeutic option for autosomal dominant polycystic kidney disease patients with enlarged kidney and liver. Ther Apher Dial 2006;10:333–341.
8.
Takei R, Ubara Y, Hoshino J, et al: Percutaneous transcatheter hepatic artery embolization for liver cysts in autosomal dominant polycystic kidney disease. Am J Kidney Dis 2007;49:744–752.
9.
Fick GM, Johnson AM, Hammomd WS, Gabow PA: Causes of death in autosomal dominant polycystic kidney disease. J Am Soc Nephrol 1995;5:2048–2056.
10.
Peter CH, Vicente ET: Autosomal dominant polycystic kidney disease. Gene Reviews, National Institutes of Health, Update 6 June 2006.
11.
Amalio T, Vicente ET, John BG, et al: Hepatic cyst infection in autosomal dominant polycystic disease. Mayo Clin Proc 1990;65:933–942.
12.
Elzinga LW, Bennett WM: Miscellaneous renal and systemic complications of autosomal dominant polycystic kidney disease including infection; in Watson ML, Torres VE (eds): Polycystic Kidney Disease. Oxford, Oxford Medical Publications, 1996, pp 483–499.
13.
Levine E, Grantham JJ: The role of computed tomography in the evaluation of adult polycystic kidney disease. Am J Kidney Dis 1981;1:99–105.
14.
Schwab SJ, Bander SJ, Klahr S: Renal infection in autosomal dominant polycystic kidney disease. Am J Med 1987;82:714–718.
15.
Amesur P, Castronuovo JJ, Chandramouly B: Infected cyst localization with gallium SPECT imaging in polycystic kidney disease. Clin Nucl Med 1988;13:35–37.
16.
Bleeker-Rovers CP, de Sevaux RG, van Hamersvelt HW, Corstens FH, Oyen WJ: Diagnosis of renal and hepatic cyst infections by 18-F-fluorodeoxyglucose positron emission tomography in autosomal dominant polycystic kidney disease. Am J Kidney Dis 2003;41:E18–E21.
17.
Muther RS, Bennet WM: Cyst fluid antibiotic concentrations in polycystic kidney disease: differences between proximal and distal cyst. Kidney Int 1981;20:519–522.
18.
Schwab S, Hinthorn D, Diederich D, Cuppage F, Grantham J: PH-dependent accumulation of clindamycin in a polycystic kidney. Am J Kidney Dis 1983;3:63–66.
19.
Elzinga LW, Golper TA, Rashad AL, Carr ME, Bennett WM: Trimethoprim-sulfamethoxazole in cyst fluid from autosomal dominant polycystic kidneys. Kidney Int 1987;32:884–888.
20.
Elzinga LW, Golper TA, Rashad AL, Carr ME, Bennett WM: Ciprofloxacin activity in cyst fluid from polycystic kidneys. Antimicrob Agents Chemother 1988;32:844–847.
21.
Hiyama L, Tang A, Miller LG: Levofloxacin penetration into a renal cyst in a patient with autosomal dominant polycystic kidney disease. Am J Kidney Dis 2006;47:E9–E13.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.