Fifteen-Year Follow-Up of Acquired Renal Cystic Disease -A Gender Difference

Abstract

In 1979, 96 patients who had undergone hemodialysis for a mean of 3 years and 4 months were entered into this study. This follow-up study revealed that the bilateral kidney volume significantly increased over 10 years in 33 male patients. Kidneys were found to have enlarged 2.7 times over the 10-year follow-up period. However, in 24 females kidney volume did not change over 10 years. This paper reports further results in 39 dialysis patients (21 males and 18 females) who were followed from the 10th to 15th year. In male patients, mean volume was 196 ± 218 ml (mean ± SD) at the 10th year and had significantly increased to 225 ± 213 ml at the 15th year (p < 0.02). In female patients, mean kidney volume was 78 ± 51 ml at the 10th year and had increased to 117 ± 91 ml at the 15th year (p < 0.01). The enlargement in kidney volume during the recent 5 years was 1.26 ± 0.39-fold in males and 1.43 ± 0.45-fold in females. These rates did not significantly differ between males and females. During this recent 5-year period, there were no surgical cases due to renal cell carcinoma. Therefore, over the entire patient-time dialysis period, there were 6 renal cell carcinomas in 1,470 patient years. In conclusion, 10- to 15-year follow-up studies of kidney size revealed that the enlargement in the kidney due to acquired cysts persisted in male patients, but the rate of increase slowed after 13.0 years of hemodialysis, while the enlargement in the kidney in female patients became significant at 17.7 years of hemodialysis, revealing the slowly progressive nature of acquired cysts in women.

Gender Differences in mRNA Expression of ATP-Binding Cassette Efflux and Bile Acid Transporters in Kidney, Liver, and Intestine of 5/6 Nephrectomized Rats

“…There is a gender difference in CKD progression; female CKD patients and animals progress slower to end-stage CKD (Ishikawa et al, 1997;Coggins et al, 1998;Silbiger and Neugarten, 2003). Consistently, in our study on CKD using Nx rats, Nx females had much less severe kidney disease than Nx males (Lu et al, 2006).…”

Cancers of the Kidney and Urinary Tract in Patients on Dialysis for End-Stage Renal Disease

“…Acquired renal cystic disease appears in both hemodialysis and peritoneal dialysis patients independently of age or primary renal disease (18); the prevalence increases with duration of dialysis (18 -20), and it has been suggested that cysts may develop more quickly in men than women (20). Although this study did not examine the occurrence of acquired renal cysts, the excess incidence of renal parenchymal cancer and its increase with time could be explained by malignant degeneration in these cysts.…”

Renal Cell and Transitional Cell Carcinoma in a Japanese Population Undergoing Maintenance Dialysis

“…Acquired renal cystic disease appears in patients on hemodialysis and peritoneal dialysis independent of patient age or primary renal disease, 10 and the prevalence increases with the duration of dialysis. 11 Thus, RCC from the acquired cysts is associated with duration of dialysis. Also, the cysts may develop more rapidly in men than in women.…”

“…Also, the cysts may develop more rapidly in men than in women. 11 On the other hand, uremic immune suppression, dialysis procedure and primary kidney diseases have been mentioned as the pathogenic conditions for the development of TCC in patients on dialysis. 4 Although real pathogenesis still remains unclear, the toxic nephropathies account for the excess risk of TCC.…”