4:12 PM Abstract No. 116 Safety of high-dose 3% sodium tetradecyl sulfate for sclerotherapy treatment of renal cysts in autosomal dominant polycystic kidney disease: a five-year study

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease and is a frequent cause for dialysis. Large, central renal cysts are thought to be especially detrimental due to local mass effect resulting in obstruction to blood and urine flow. Over the last five years we have performed cyst sclerotherapy using 3% sodium tetradecyl sulfate (STS). Food and Drug Administration approved dosage of STS is ≤10 mL; however, this relates to its on-label intravascular use. The aim of this study is to assess the safety profile of high-dose (>10 mL) 3% STS sclerotherapy for the treatment of renal cysts in ADPKD. A retrospective analysis of patients diagnosed with ADPKD at the Hereditary Kidney Disease Clinic, Toronto who had undergone percutaneous renal cyst sclerotherapy was performed. Patients treated between August 2014 to August 2019 were included. Patients were divided into groups who received treatments that utilized >10 mL of STS (high-dose) and ≤10 mL STS (low-dose). MRI was used to determine the volume of the targeted kidney(s). Electronic patient records were reviewed for complications. Currently, data for 107 sclerotherapy procedures in patients (mean age, 52.4 years) who have undergone renal sclerotherapy up until August 2017 has been analyzed (high-dose STS = 62; low-dose STS = 45). Mean length of follow-up was 15.4 months. Target kidney volume decrease as measured on MRI was greater in patients who received high-dose STS (high-dose STS = 387 CC, low-dose STS = 178 CC; P <0.05). There was no statistically significant difference between the two groups in terms of total adverse events (high-dose STS = 14, low-dose STS = 5); however, post procedure pain was more frequent in patients receiving high-dose STS group (high-dose STS = 9, low-dose STS = 1 P <0.05). No major complications occurred. High intracystic doses of STS are associated with more effective cyst volume reduction but no apparent increase risk of adverse events apart from postprocedural pain.