Prevalence of Renal Artery and Kidney Abnormalities by Computed Tomography among Healthy Adults
Prevalence of Renal Artery and Kidney Abnormalities by Computed Tomography among Healthy Adults
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DOI：
10.2215/cjn.07641009
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发表时间：
2010-03-01
影响因子：
9.8
通讯作者：
Rule, Andrew D.
中科院分区：
文献类型：
--
作者：
Lorenz, Elizabeth C.;Vrtiska, Terri J.;Rule, Andrew D.
背景和目的：在接受CT扫描的患者中，意外肾动脉和肾脏异常的处理是一个临床挑战，因为它们在健康受试者中的频率还没有得到准确的估计。因此，在接受方案评估的一大批潜在肾脏捐赠者中，确定了这些异常的患病率和处理。设计、设置、参与者和测量：确定了梅奥诊所在2000年至2008年期间接受CT血管成像和尿路造影术作为肾脏捐赠者评估的一部分的所有患者。肾动脉和肾脏异常的放射学报告被摘录。结果：在1957名潜在肾捐献者中，平均+/-SD年龄为43+/-12岁，其中58%为女性。最常见的异常是肾结石(11%)、局灶性瘢痕(3.6%)、纤维肌肉发育不良(2.8%)和其他肾动脉狭窄或动脉硬化(5.3%)。纤维肌肉发育不良、局灶性瘢痕、实质萎缩和上尿路扩张在女性中更为常见。肾动脉狭窄、局灶性瘢痕形成和不明肿块随年龄增长而增加。总体而言，25%的潜在捐赠者至少有一项异常。然而，这些意外的放射学异常导致仅6.7%的潜在捐献者被排除在献血之外。结论：肾动脉和肾脏的意外放射学异常很常见。大多数的影像表现被认为不足以阻止肾脏捐赠，但还需要进一步的研究来确定它们的临床相关性。
Background and objectives: Management of incidental renal artery and kidney abnormalities in patients undergoing computed tomography scans is a clinical challenge because their frequency in healthy subjects has not been precisely estimated. Therefore, the prevalence and management of these abnormalities were determined among a large cohort of potential kidney donors undergoing protocol evaluations.Design, setting, participants, & measurements: All patients at the Mayo Clinic who under-went computed tomographic angiography and urography as part of their kidney donor evaluation between 2000 and 2008 were identified. Radiographic reports were abstracted for abnormalities of the renal arteries and kidneys. The prevalence of radiographic abnormalities was stratified by age and gender, and the effect on approval for kidney donation was determined.Results: Among 1957 potential kidney donors, the mean +/- SD age was 43 +/- 12 years, and 58% were women. The most common abnormalities were kidney stones (11%), focal scarring (3.6%), fibromuscular dysplasia (2.8%), and other renal artery narrowing or atherosclerosis (5.3%). Fibromuscular dysplasia, focal scarring, parenchymal atrophy, and upper tract dilation were more common in women. Renal artery narrowing, focal scarring, and indeterminate masses increased with age. Overall, 25% of potential donors had at least one abnormality. However, these incidental radiographic abnormalities contributed to exclusion from donation in only 6.7% of potential donors.Conclusions: Incidental radiographic abnormalities of the renal arteries and kidneys are common. The majority of imaging findings are not perceived to be harmful enough to prevent kidney donation, but future studies are needed to determine their clinical relevance.