ISSN: 1305-385X
Hakkında: Özel sayılar şeklinde yayınlanır.
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Acquired Cystic Kidney Disease
Dr. Lütfullah ALTINTEPEa
aNefroloji BD, Selçuk Üniversitesi Meram Tıp Fakültesi, KONYA
Acquired cystic kidney disease (ACKD) can develop during the period of chronic renal insufficiency. Failing nephrons hypertrophy in response to a variety of growth factors associated with uremia, leading to cyst formation. ACKD incidence and prevalence depend on the uremic milieu, and it is associated with advancing age and length of time on dialysis. It affects men more than women. The cysts are always bilateral. Most patients are asymptomatic. However, sudden hematuria, anemia or erythrocytosis, fever of unknown origin, and lumbar or flank pain have been reported with some frequency. A patient with end stage renal disease who reports new onset hematuria should be investigated for a bleeding cyst. Of course, hematuria, particularly in conjunction with lumbar pain and fever of unknown origin can also represent renal cell carcinoma (RCC). Because ACKD has few associated symptoms, RCC which develops in this setting often presents in an asymptomatic fashion. Screening should be selective. Ultrasonography remains a good initial test to assess cyst size and burden. However, both CT scan and MRI are more useful to detect small tumors and differentiate them from hemorrhagic cysts. Currently, indications do not exist for the routine evaluation of ACKD in pretransplant or posttransplant patients.Keywords: Acquired cystic kidney disease, ACKD, uremia, renal cell karsinomaTurkiye Klinikleri J Int Med Sci 2005, 1(4):56-64
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