A case of unilateral nephrectomy performed for autosomal dominant polycystic kidney disease with marked unilateral enlargement

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is characterized by the occurrence of multiple cysts that increase the size of both kidneys, progressively reducing kidney function. Usually the cysts occur bilaterally, and there is no difference in the degree of cyst enlargement between the left and right. Here, we report a case of ADPKD in which kidney size increased markedly on the left side and was accompanied by severe abdominal distension and discomfort. Renal dynamic scintigraphy revealed a severe reduction in function of the left kidney compared with the right. Open left nephrectomy was performed. No change in renal function was observed postoperatively [preoperative estimated glomerular filtration rate (eGFR): 57.6 mL/min/1.73 m, 3-month postoperative eGFR: 56.4 mL/min/1.73 m], and the abdominal symptoms subsided. When one kidney is markedly larger than the other, the cause and status of the laterality should be evaluated by using renal dynamic scintigraphy in addition to other examinations such as computed tomography or magnetic resonance imaging. Unilateral nephrectomy should be considered as a potential treatment.

Exceptionally Large Kidneys in Autosomal Dominant Polycystic Disease in India

“…Patients have a wide range of clinical manifestations, including pain, hematuria, vomiting, hypertension, and kidney dysfunction. In many cases, the clinical presentation is directly related to renal cyst enlargement [ 5 ]. Episodic renal colic is quite often due to cyst hemorrhage, infection, and stone.…”