Dataset Information

Cyst infection in autosomal dominant polycystic kidney disease: penetration of meropenem into infected cysts.

ABSTRACT:

Background

Cyst infection is a common and serious complication of autosomal dominant polycystic kidney disease (ADPKD) that is often refractory. Carbapenems are frequently needed to treat to patients with refractory cyst infection, but little is known about the penetration of newer water-soluble carbapenems into cysts. This study investigated the penetration of meropenem (MEPM) into infected cysts in patients with ADPKD.

Methods

Between August 2013 and January 2014, 10 ADPKD patients (14 infected cysts) receiving MEPM at Toranomon Hospital underwent drainage of infected cysts and definite cyst infection was confirmed through detection of neutrophils by cyst fluid analysis. The serum concentration of MEPM was measured just after intravenous administration and was compared with that in fluid aspirated from infected cysts.

Results

In the patients undergoing cyst drainage, the mean serum MEPM concentration was 35.2?±?12.2 ?g/mL (range: 19.7 to 59.2 ?g/mL, while the mean cyst fluid concentration of MEPM in the drained liver cysts (n?=?12) or kidney cysts (n?=?2) was 3.03?±?2.6 ?g/mL (range: 0 to 7.3 ?g/mL). In addition, the mean cyst fluid/serum MEPM concentration ratio was 9.46?±?7.19% (range: 0 to 18.8%). There was no relationship between the cyst fluid concentration of MEPM and the time until drainage after MEPM administration or between the cyst fluid/serum MEPM concentration ratio and the time until drainage.

Conclusion

These findings suggest that MEPM shows poor penetration into infected cysts in ADPKD patients.

Trial registration

This study was registered with the University Hospital Medical Information Network (UMIN) as "Penetration of meropenem into cysts in patients with autosomal dominant polycystic kidney disease (ADPKD)", UMIN ID 000011292 on July 26th, 2013.

SUBMITTER: Hamanoue S

PROVIDER: S-EPMC6194587 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Publications

Cyst infection in autosomal dominant polycystic kidney disease: penetration of meropenem into infected cysts.

Hamanoue Satoshi S Suwabe Tatsuya T Ubara Yoshifumi Y Kikuchi Koichi K Hazue Ryo R Mise Koki K Ueno Toshiharu T Takaichi Kenmei K Matsumoto Kana K Morita Kunihiko K

BMC nephrology 20181019 1

<h4>Background</h4>Cyst infection is a common and serious complication of autosomal dominant polycystic kidney disease (ADPKD) that is often refractory. Carbapenems are frequently needed to treat to patients with refractory cyst infection, but little is known about the penetration of newer water-soluble carbapenems into cysts. This study investigated the penetration of meropenem (MEPM) into infected cysts in patients with ADPKD.<h4>Methods</h4>Between August 2013 and January 2014, 10 ADPKD patie ...[more]

PMID: 30340529

Similar Datasets

Project description:Background and objectivesTo evaluate the growth pattern of kidney cyst number and cyst volume in association with kidney size, demographics, and genotypes in autosomal dominant polycystic kidney disease.Design, setting, participants, & measurementsKidney cyst number and cyst volume were measured from serial magnetic resonance images, giving a maximum follow-up of 14.23 years, from 241 patients with autosomal dominant polycystic kidney disease (15-46 years old at baseline). The growth pattern was analyzed, in association with sex, age, height-adjusted total kidney volume, and genotype, using linear mixed models of repeated measurements and tests of interactions with age (as a time-dependent covariate) to assess rates of change over time. Models were also fit using Irazabal class. Genotypic groups were characterized as either (1) PKD1 truncating, PKD1 nontruncating, and PKD2 plus patients with no mutation detected; or (2) in combination with PKD1 mutation strength groups.ResultsImaging and genetic data were collected (at least one visit) for 236 participants. The mean height-adjusted total cyst number increased exponentially over time from a baseline value of 762 to 1715 at the last clinic visit, while the mean height-adjusted total cyst volume increased exponentially from 305 to 770 ml. Height-adjusted total kidney volume, height-adjusted total cyst number, and height-adjusted total cyst volume were all highly correlated over time. Female participants and participants with larger height-adjusted total kidney volume at baseline showed smaller rates of change in the log of height-adjusted total cyst number and cyst volume. PKD1 was associated with significant increases in both cyst number and volume at a given age, but genotype did not significantly affect the rate of growth.ConclusionsBoth height-adjusted total cyst number and height-adjusted total cyst volume increased exponentially and more than doubled over 14.23 years of follow-up. Compared with PKD2 plus no mutation detected, PKD1 was associated with a greater cyst number and volume at a given age, but no significant difference in the rate of growth.

Dataset Information

Cyst infection in autosomal dominant polycystic kidney disease: penetration of meropenem into infected cysts.

Background

Methods

Results

Conclusion

Trial registration

Publications

Cyst infection in autosomal dominant polycystic kidney disease: penetration of meropenem into infected cysts.

Similar Datasets

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