Sugimoto Hisashi, Suwabe Tatsuya, Kurihara Shigekazu, Oba Yuki, Ikuma Daisuke, Mizuno Hiroki, Sekine Akinari, Yamanouchi Masayuki, Miki Katsuyuki, Yokoyama Takayoshi, Nakamura Yuki, Ishii Yasuo, Wada Takehiko, Sawa Naoki, Ubara Yoshifumi
Nephrology Center and the Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan.
Clin Nephrol Case Stud. 2024 Dec 20;12:83-89. doi: 10.5414/CNCS111450. eCollection 2024.
Emphysematous polycystic renal infection (EPRI) has a poor prognosis with conservative management, and early surgical nephrectomy has been recommended. However, percutaneous cyst drainage may be a possible treatment option. We experienced 6 patients with autosomal dominant polycystic kidney disease (ADPKD) presenting with EPRI. Three patients developed EPRI after renal transarterial embolization (TAE), and the other 3 developed EPRI independently of renal TAE. Two of the patients had only one cyst with gas formation, and the causative organism was sensitive to antibiotics; these patients were cured by cyst drainage and antibiotic therapy. However, in 3 patients with severe renal enlargement and gas formation in multiple cysts, the causative organism was antibiotic resistant and cyst drainage was not effective, so surgical nephrectomy was performed and the disease effectively treated. Surgical nephrectomy should be considered in patients with multiple cysts with gas formation and severe renal enlargement.
气肿性多囊肾感染（EPRI）采用保守治疗预后较差，因此建议早期行手术肾切除术。然而，经皮囊肿引流可能是一种可行的治疗选择。我们诊治了6例常染色体显性多囊肾病（ADPKD）合并EPRI的患者。3例患者在肾动脉栓塞术（TAE）后发生EPRI，另外3例独立于肾TAE发生EPRI。其中2例患者仅有一个含气囊肿，致病菌对抗生素敏感，经囊肿引流和抗生素治疗后治愈。然而，3例有多发性囊肿且严重肾肿大并含气的患者，致病菌耐药，囊肿引流无效，因此实施了手术肾切除术，疾病得到有效治疗。对于有多发性含气囊肿和严重肾肿大的患者，应考虑手术肾切除术。
