Characteristics of Renal Cystic and Solid Lesions Based on Contrast-Enhanced Computed Tomography of Potential Kidney Donors
Characteristics of Renal Cystic and Solid Lesions Based on Contrast-Enhanced Computed Tomography of Potential Kidney Donors
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DOI：
10.1053/j.ajkd.2011.12.022
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发表时间：
2012-05-01
影响因子：
13.2
通讯作者：
Vrtiska, Terri J.
中科院分区：
文献类型：
--
作者：
Rule, Andrew D.;Sasiwimonphan, Kewalee;Vrtiska, Terri J.
背景：尽管获得性肾囊性疾病发生于晚期肾衰竭，但少量肾囊肿的存在被认为与健康成人关系不大。本研究的目的是详细说明肾囊性和实性病变，并确定其与临床特征的关系。研究设计：临床病理相关性。背景和参与者：2000-2008年在梅奥诊所接受标准化评估的潜在肾脏捐赠者。预测因素：年龄、肾功能和慢性肾脏疾病危险因素。测量：对比增强计算机断层图像显示肾囊性和实性病变。结果：囊肿数量、直径和位置。结果：在排除8例囊性疾病患者（其中7例常染色体显性多囊性肾病）后，有1948例潜在肾脏供体（42%为男性，平均年龄43岁）。皮质囊肿、髓样囊肿或盆腔旁囊肿（>= 5mm）分别为12%、14%和2.8%。在19-49岁年龄组中，分别有39%、22%、7.9%和1.6%的患者有皮质或髓质囊肿，>= 2,>= 5,>= 10,>= 20mm直径。在50-75岁年龄组中，63%、43%、22%和7.8%的患者有皮质或髓质囊肿，其直径分别为>= 2、>= 5、>= 10和>= 20mm。皮层和髓质囊肿数量的97.5%随着年龄的增长而增加（60- 69岁组男性10个，女性4个）。在年龄和性别调整后，在一些分析中，皮质和髓质囊肿>= 5 mm与较高的24小时尿白蛋白排泄量、体表面积增加、高血压和较高的肾小球滤过率相关。血管平滑肌脂肪瘤、高密度囊肿、增强肿块或囊肿与恶性肿瘤相关的发生率分别为2.2%、1.2%和0.6%，且与年龄有关(P
Background: The presence of a few renal cysts is considered of little relevance in healthy adults, although acquired renal cystic disease occurs in advanced kidney failure. The objective of this study was to detail renal cystic and solid lesions and identify any association with clinical characteristics.Study Design: Clinical-pathologic correlation.Setting & Participants: Potential kidney donors undergoing a standardized evaluation at the Mayo Clinic in 2000-2008.Predictors: Age, kidney function, and chronic kidney disease risk factors.Measurements: Renal cystic and solid lesions by contrast-enhanced computed tomographic images.Outcomes: Cyst number, diameter, and location.Results: After excluding 8 with cystic disease, 7 of whom had autosomal dominant polycystic kidney disease, there were 1,948 potential kidney donors (42% men; mean age, 43 years). A cortical, medullary, or parapelvic cyst >= 5 mm was present in 12%, 14%, or 2.8%. For ages 19-49 years, 39%, 22%, 7.9%, and 1.6% had a cortical or medullary cyst >= 2, >= 5, >= 10, and >= 20 mm in diameter. For ages 50-75 years, 63%, 43%, 22%, and 7.8% had a cortical or medullary cyst >= 2, >= 5, >= 10, and >= 20 mm in diameter. The 97.5th percentile for number of cortical and medullary cysts >= 5 mm increased with age (10 for men and 4 for women in the 60- to 69-year group). After age and sex adjustment, cortical and medullary cysts >= 5 mm were associated with higher 24-hour urine albumin excretion, as well as increased body surface area, hypertension, and higher glomerular filtration rate in some analyses. Angiomyolipomas, hyperdense cysts, and enhancing masses or cysts with concerning features for malignancy occurred in 2.2%, 1.2%, and 0.6% and were associated with older age (P