Multicystic Transformation of Kidneys in Chronic Renal Failure

Mickisch, O; Bommer, Jürgen; Bachmann, S.; Waldherr, Rüdiger; Mann, Johannes F.E.; Ritz, Eberhard

doi:10.1159/000183288

Cited by 85 publications

(44 citation statements)

References 18 publications

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“…In 1980, Bommer et al [5]reported that acquired renal cysts were observed by CT scan in patients with predialysis end-stage renal disease. In other words, acquired cysts develop in patients with serum creatinine >2 mg/dl [7]. The most important factor for developing acquired cyst is the duration of chronic renal failure or dialysis.…”

Section: Discussionmentioning

confidence: 99%

Incidence of Acquired Renal Cysts in Biopsy Specimens

Liu

Ishikawa

Horiguchi

2000

Nephron

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Aims: This study investigated whether or not acquired renal cysts develop in patients with mild chronic renal failure. Methods: A retrospective study was carried out using renal biopsy specimens from 720 patients. A renal cyst was defined as a tubule dilated >200 µm. Results: Renal cysts were found in 21 of 720 renal biopsy specimens. Serum creatinine of 21 patients with renal cysts was significantly higher than that of 699 patients without cysts (2.59 ± 2.64 vs. 1.09 ± 0.79 mg/dl) (p < 0.0001). Poor renal function (serum creatinine >1.6 mg/dl) reveals more cyst formation on biopsy specimens than good renal function (serum creatinine <1.5 mg/dl). Cysts were observed in 11 of 607 (1.8%) patients less than 50 years of age and in 10 of 113 (8.8%) patients over 51 years. To exclude simple cysts which are commonly observed in older subjects, 11 patients under 50 years of age were extensively examined. Mean serum creatinine was 2.98 ± 3.06 mg/dl (0.7–10.4 mg/dl). These 11 patients revealed low creatinine clearance of 47.5 ± 25.6 ml/min (5–71 ml/min). Creatinine clearances in 7 patients were 52–71 ml/min (serum creatinine 0.7–2.0 mg/ dl). One of 11 biopsy specimens with cysts was examined by immunohistochemistry on lectin. This specimen was positive for tetragonolobus lectin and negative for peanut lectin, suggesting that the epithelial cells lining the cyst were derived from proximal tubules, unlike those of simple cysts. Conclusion: These results suggest that low normal renal function such as creatinine clearances 52–71 ml/min due to nephron loss is sufficient to induce acquired cyst development in various renal diseases.

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Section: Discussionmentioning

confidence: 99%

Incidence of Acquired Renal Cysts in Biopsy Specimens

Liu

Ishikawa

Horiguchi

2000

Nephron

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“…El tumor renal en el paciente trasplantado aparece en edades más jóvenes que en la población general con una edad media de aparición entre 44 y 47 años; siendo la proporción hombre mujer de 2 a 17,10 . La ERQA fue descrita por primera vez en 1977 por Dunnill et al, definiéndose como la sustitución de mas del 25% del parénquima renal en pacientes con IRC por quistes córtico-medulares que se desarrollarían durante la diálisis, aunque se han descrito en pacientes con IRC prediálisis 15,18 . Etiopatogéni-camente se han propuesto distintos mecanismos en la ERQA: obstrucción por depósitos de oxalato o fibrosis, productos tóxicos acumulados que alterarían la membrana basal, alteraciones vasculares secundarias a la hemodiálisis, factores renotrópicos de crecimiento 17 .…”

Section: Discussionunclassified

“…Histológicamente se caracteriza por la presencia de quistes, cubiertos de epitelio cuboidal, columnar, o hiperplásico con proyecciones papilares. estudios patológicos han demostrada la continuidad de estos quistes con los túbulos renales, sugiriéndose el origen quístico en los túbulos, sin poder determinar si el origen es del túbulo proximal o distal 8,9,15 . Así los quistes tapizados por epitelio cuboidal se estratificaría, con posterior hiperplasia y displasia que daría lugar al tumor 18 .…”

Section: Discussionunclassified

“…La literatura se coincide mayoritariamente que el periodo entre el inicio de la hemodiálisis y la aparición de EQRA y el CCR son consecuencias de la IRC terminal y no secundarias al tiempo en hemodiálisis. Estudios realizados en pacientes con uremia tanto en programa de diálisis como sin él, presentan quistes renales que aumentan a medida que lo hace la creatinina sérica; de esta manera la relación que tendría la diálisis con la EQRA no sería de causa efecto sino que se debería al aumento de la expectativa de vida de los pacientes en diálisis 15,18 . La ERQA debe ser considerado como un potencial estadio premaligno con posibilidad de progresión a tumor en un 20%, siendo la incidencia de tumores renales del 14 al 20%, pudiendo desarrollar carcinoma de células renales entre 30 a 40 superior a la población general 2,7,8,[15][16][17][18] .…”

Section: Discussionunclassified

“…Estudios realizados en pacientes con uremia tanto en programa de diálisis como sin él, presentan quistes renales que aumentan a medida que lo hace la creatinina sérica; de esta manera la relación que tendría la diálisis con la EQRA no sería de causa efecto sino que se debería al aumento de la expectativa de vida de los pacientes en diálisis 15,18 . La ERQA debe ser considerado como un potencial estadio premaligno con posibilidad de progresión a tumor en un 20%, siendo la incidencia de tumores renales del 14 al 20%, pudiendo desarrollar carcinoma de células renales entre 30 a 40 superior a la población general 2,7,8,[15][16][17][18] . La agresividad del tumor renal en pacientes con ERQA es baja, ya que suelen ser neoformaciones de pequeño tamaño, bien diferenciadas y de curso asintomático, siendo poco frecuente el desarrollo de metástasis (inferior al 1%) 21,22 .…”

Section: Discussionunclassified

See 2 more Smart Citations

Metastasis en injerto renal de adenocarcinoma renal primario

García

Revilla

Mayayo

et al. 2004

Actas Urológicas Españolas

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RESUMEN METÁSTASIS EN INJERTO RENAL DE ADENOCARCINOMA RENAL PRIMARIOLa enfermedad renal quística adquirida (E.R.Q.A), es un factor de riesgo para el desarrollo de carcinoma renal en los riñones propios, tras el trasplante renal (T.R.). El desarrollo de un tumor primitivo del injerto renal es infrecuente. De otro lado, la incidencia de tumor primitivo en el injerto renal es infrecuente, pero la presencia de metástasis en el de un tumor epitelial es excepcional, siendo este el segundo caso de literatura de metástasis de tumor epitelial en injerto renal; y el primer caso descrito de metástasis de carcinoma de células renales (C.C.R.), sobre injerto renal. El caso de un paciente con TR normofuncionante y ERQA que desarrolla CCR en riñón propio, con metástasis sobre el injerto renal.PALABRAS CLAVE: Enfermedad renal quística adquirida. Trasplante renal. Adenocarcinoma renal. ABSTRACTMETASTASIS IN RENAL GRAFT OF PRIMARY RENAL ADENOCARCINOMA Acquired cystic renal disease (A.C.R.D.) is a risk factor for the development of renal carcinoma in the patient's own kidney after renal transplant (R.T.). development of a primitive tumor in the renal graft is infrequent, but the presence of metastasis of an epithelial tumor is very rare. This is the second case reported in the literature of metastasis of an epithelial tumor in the renal graft and the first case described of renal cell carcinoma metastasis (R.C.C.) in the renal graft. This paper describes the case of a patient with a normally functioning renal transplant and A.C.R.D. who develops RCC in his own kidney, with metastasis in the renal graft.

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Ultrasonography of the native kidney in dialysis and transplant patients

Allan

1992

J of Clinical Ultrasound

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The native kidneys in patients on dialysis or after transplantation tend to be overlooked until problems occur in relation to them. Their appearance can be variable and does not bear any consistent relationship to the cause of the renal failure; although in some cases, such as polycystic kidney disease, there are specific changes to be seen. Size can also be variable with little correlation to pathology in most cases. Acquired cystic disease of the kidneys is seen in up to 92% of long-term dialysis patients and also can be seen in patients with chronic renal failure. Proliferative changes occur in the kidneys which result in the development of cysts, adenomas and, in approximately 1% to 2% of dialysis patients, malignant lesions. It is probable that these changes are caused by a combination of factors, including circulating agents which are not cleared adequately by dialysis. There is some evidence that these changes are halted, or even reversed following a successful transplant. Problems with infection and hemorrhage may occur in patients with polycystic kidney disease. Problems with infection may also occur in patients with calculi, with longstanding pyelonephritis, or reflux.

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Multicystic Transformation of Kidneys in Chronic Renal Failure

Cited by 85 publications

References 18 publications

Incidence of Acquired Renal Cysts in Biopsy Specimens

Incidence of Acquired Renal Cysts in Biopsy Specimens

Metastasis en injerto renal de adenocarcinoma renal primario

Ultrasonography of the native kidney in dialysis and transplant patients

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