Development of acquired cystic disease and adenocarcinoma of the kidney in glomerulonephritic chronic hemodialysis patients.
Development of acquired cystic disease and adenocarcinoma of the kidney in glomerulonephritic chronic hemodialysis patients.
复制标题
肾小球肾病慢性血液透析患者获得性囊性病变和肾腺癌的发展。
作者：
I. Ishikawa;Y. Saito;Z. Onouchi;H. Kitada;S. Suzuki;S. Kurihara;T. Yuri;A. Shinoda
对长期血液透析患者的收缩肾的命运进行了检查。应用计算机辅助断层扫描技术对96例慢性肾小球肾炎慢性肾功能衰竭血液透析患者的肾脏总体积进行了测量。评价肾实质中囊肿和/或肿瘤的存在。肾脏体积逐渐减少，直至透析开始后3年。然而，在透析4年后，在一些病例中，它又增加了。43.5%的透析少于3年的患者和79.3%的透析超过3年的患者发现多发性囊肿。透析3年以上肾总体积超过50 ml者100%有肾积水。4例透析5年以上者均表现为获得性肾囊肿，行双侧肾切除术。4例手术切除者中3例合并腺癌和多发性腺瘤，合并获得性肾脏囊性病变。另1例为囊内上皮增生。这些结果表明，长期血液透析与获得性肾脏囊性疾病的发病率非常高。在肾小球肾炎患者中，收缩的肾脏经常增大，并且肾腺癌的发生率很高，导致血液透析治疗。
The fate of the contracted kidney in long-term hemodialysis patients was examined. Total kidney volume was measured by computer assisted tomography in 96 chronically hemodialyzed patients with chronic renal failure due to chronic glomerulonephritis. The presence of cysts and/or tumor in the renal parenchyma was evaluated. Kidney volume decreased progressively up to 3 years after the start of dialysis. However, after 4 years of dialysis, it then increased in a number of cases. Multiple cysts were found in 43.5% of patients on dialysis for less than 3 years and in 79.3% of patients who had been on dialysis for more than 3 years. They were found in 100% of those whose total kidney volume exceeded 50 ml despite more than 3 years dialysis. Bilateral nephrectomy was performed in 4 cases who had been dialyzed for more than 5 years and all showed acquired cystic disease of the kidney. Three out of 4 resected cases had adenocarcinoma and multiple adenomas in addition to acquired cystic disease of the kidneys. The other had intracystic epithelial hyperplasia. These results suggest that long-term hemodialysis is associated with a very high incidence of acquired cystic disease of the kidney. There is frequent enlargement of the contracted kidney, and a high incidence of renal adenocarcinoma in patients with glomerulonephritis leading to treatment with hemodialysis.