Reducing Polycystic Liver Volume in ADPKD: Effects of Somatostatin Analogue Octreotide
Reducing Polycystic Liver Volume in ADPKD: Effects of Somatostatin Analogue Octreotide
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DOI：
10.2215/cjn.05380709
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发表时间：
2010-05-01
影响因子：
9.8
通讯作者：
Ruggenenti, Piero
中科院分区：
文献类型：
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作者：
Caroli, Anna;Antiga, Luca;Ruggenenti, Piero
背景和目标：多囊肝是常染色体显性遗传性多囊肾病（ADPKD）的常见表现，目前尚无药物治疗。在一项前瞻性、随机、双盲、交叉研究中，在12例ADPKD患者中，与安慰剂相比，（40 mg，每28天一次）治疗更有效地限制了肾脏体积的生长。设计、设置、参与者和测量：在上述研究的次要事后分析中，与安慰剂相比，评价奥曲肽诱导的肝脏体积变化以及伴随的肝脏和肾脏体积变化之间的关系。那些分析肝脏和肾脏的体积是盲目的treatment.Results：肝体积显着下降，从1595 +/- 478毫升到1524 +/- 453毫升与奥曲肽，而他们没有明显的变化与安慰剂。两个治疗阶段之间的肝脏体积变化存在显著差异（-71 +/- 57 ml vs +14 +/- 85 ml）。实质体积从1506 +/- 431 ml减少至1432 +/- 403 ml，充分解释了奥曲肽诱导的肝脏体积减少。在奥曲肽治疗期间，肝脏体积的变化与肾脏体积的伴随变化显著相关（r = 0.67），但在安慰剂治疗期间不相关。两种治疗组的肝脏和肾脏体积变化显著不同（奥曲肽：71 +/- 57 ml vs +71 +/- 107;安慰剂：+14 +/- 85 ml vs +162 +/- 114），但肝脏的净减少（-85 +/- 103 ml）和肾脏（-91 +/-125 ml）的体积增长与安慰剂组相似。结论：奥曲肽治疗可减少ADPKD患者的肝脏体积，且安全。Clin J Am Soc Nophrol 5：783-789，2010. doi：10.2215/CJN.05380709
Background and objectives: No medical treatment is available for polycystic liver disease, a frequent manifestation of autosomal-dominant polycystic kidney disease (ADPKD). In a prospective, randomized, double-blind, crossover study, 6 months of octreotide (40 mg every 28 days) therapy limited kidney volume growth more effectively than placebo in 12 patients with ADPKD.Design, setting, participants, & measurements: In this secondary, post hoc analysis of the above study, octreotide-induced changes in liver volumes compared with placebo and the relationship between concomitant changes in liver and kidney volumes were evaluated. Those analyzing liver and kidney volumes were blinded to treatment.Results: Liver volumes significantly decreased from 1595 +/- 478 ml to 1524 +/- 453 ml with octreotide whereas they did not appreciably change with placebo. Changes in liver volumes were significantly different between the two treatment periods (-71 +/- 57 ml versus +14 +/- 85 ml). Octreotide-induced liver volume reduction was fully explained by a reduction in parenchyma volume from 1506 +/- 431 ml to 1432 +/- 403 ml. Changes in liver volumes were significantly correlated with concomitant changes in kidney volumes (r = 0.67) during octreotide but not during placebo treatment. Liver and kidney volume changes significantly differed with both treatments (octreotide: 71 +/- 57 ml versus +71 +/- 107; placebo: +14 +/- 85 ml versus +162 +/- 114), but net reductions in liver (-85 +/- 103 ml) and kidney (-91 +/- 125 ml) volume growth on octreotide versus placebo were similar.Conclusions: Octreotide therapy reduces liver volumes in patients with ADPKD and is safe. Clin J Am Soc Nophrol 5: 783-789, 2010. doi: 10.2215/CJN.05380709