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Evidence of nonsurgical treatment for polycystic liver disease

Authors
 Jeong-Ju Yoo  ;  Hye In Jo  ;  Eun-Ae Jung  ;  Jae Seung Lee  ;  Sang Gyune Kim  ;  Young Seok Kim  ;  Beom Kyung Kim 
Citation
 THERAPEUTIC ADVANCES IN CHRONIC DISEASE, Vol.13 : 20406223221112563, 2022-07 
Journal Title
THERAPEUTIC ADVANCES IN CHRONIC DISEASE
ISSN
 2040-6223 
Issue Date
2022-07
Keywords
efficacy ; intervention ; medication ; meta-analysis ; polycystic liver disease ; safety
Abstract
Background: Polycystic liver disease (PCLD) is the most common extrarenal manifestation of polycystic kidney disease. There is an urgent need to assess the efficacy and safety of nonsurgical modalities to relieve symptoms and decrease the severity of PCLD. Herein, we aimed to evaluate the efficacy of the nonsurgical treatment of PCLD and the quality of life of affected patients.

Methods: PubMed, Ovid, MEDLINE, EMBASE, and the Cochrane Library were searched for studies on the nonsurgical modalities, either medications or radiological intervention to manage PCLD. Treatment efficacy, adverse events (AEs), and patient quality of life were evaluated.

Results: In total, 27 studies involving 1037 patients were selected. After nonsurgical treatment, liver volume decreased by 259 ml/m [mean change (Δ) of 6.22%] and the effect was higher in the radiological intervention group [-1617 ml/m (-15.49%)] than in the medication group [-151 ml/m (-3.78%)]. The AEs and serious AEs rates after overall nonsurgical treatment were 0.50 [95% confidence interval (CI): 0.33-0.67] and 0.04 (95% CI: 0.01-0.07), respectively. The results of the SF-36 questionnaire showed that PCLD treatment improved physical function [physical component summary score of 4.18 (95% CI: 1.54-6.83)] but did not significantly improve mental function [mental component summary score of 0.91 (95% CI: -1.20 to 3.03)].

Conclusion: Nonsurgical treatment was effective and safe for PCLD, but did not improve the quality of life in terms of mental health. Radiological intervention directly reduces hepatic cysts, and thus they should be considered for immediate symptom relief in patients with severe symptoms, whereas medication might be considered for maintenance treatment.

Registration number: PROSPERO (International Prospective Register of Systematic Reviews) CRD42021279597.
Files in This Item:
T202300715.pdf Download
DOI
10.1177/20406223221112563
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Lee, Jae Seung(이재승) ORCID logo https://orcid.org/0000-0002-2371-0967
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/193160
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