Regression of Acquired Cystic Disease of the Kidney after Successful Renal Transplantation

Ishikawa, Isao; Yuri, Takehisa; Kitada, Hirohisa; Shinoda, Akira

doi:10.1159/000166738

Cited by 114 publications

(49 citation statements)

References 3 publications

(5 reference statements)

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“…The etiology of this cyst development is unknown [2, 10, 11, 12, 13, 14, 15, 16], however accumulation of growth factors in chronic renal failure may be a cause because the incidence and severity of acquired cyst development are dependent on the duration of dialysis or chronic renal failure and acquired cysts regress rapidly after successful renal transplantation [17]. …”

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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“…In the dialysis case, however, the epithelial cells lining the cyst walls are originally normal and the cysts and subsequent neoplasms are considered to be induced by chronic stimulation by a particular factor(s) accumulated in the blood and renal tissue during ongoing treatment: 14 if the patient successfully undergoes renal transplantation, some of the cysts may disappear. 15 The neoplastic development in toad hybrids is also reminiscent of the historically famous hereditary melanoma in platy fishswordtail Xiphophorus hybrids, 16,17 that is now known to be induced by an over expression of mutated receptor tyrosine kinase Xmrk and reduction or absence of products of the suppressor gene R. 18,19 This unique toad model might similarly be useful for gaining more insight into carcinogenesis in hybrids.…”

Section: Discussionmentioning

confidence: 99%

Polycystic kidney and renal cell carcinoma in Japanese and Chinese toad hybrids

Masahito

Nishioka

Kondo

et al. 2002

Intl Journal of Cancer

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Frequent development of renal cell carcinomas in hybrids between Japanese toads (Bufo japonicus) and imported Chinese toads (Bufo raddei) was first reported by 2 of our authors in 1987. Such renal tumors of toads had never been observed previously in the laboratory. To confirm the observation and to establish a new animal model system, hybrids between female Japanese and male Chinese toads were newly generated from 3 pairs of parents and pathological changes in their kidneys were examined sequentially over 6 years. In hybrids from 2 of the 3 pairs, bilateral polycystic kidney developed at a high frequency from 3 months after fertilization, this being associated with the emergence of atypical, premalignantappearing cells in proximal tubules. Papillary lesions developed after 12 months and renal cell carcinomas after 48 months. Such pathological changes were never seen in nonhybrid Chinese or Japanese toads. Electron microscopy showed no evidence of any viral participation. This unique toad model may prove useful for investigation of the underlying mechanisms of genetically determined renal cell carcinogenesis.

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“…[13] Renal transplant recipients have a significantly lower prevalence and severity of ACKD, and in some cases experience regression of ACKD after transplantation. [14,15] This suggests that restoration of renal function may slow or reverse the progression of ACKD.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Online Hemodiafiltration Does Not Reduce the Frequency and Severity of Acquired Cystic Kidney Disease in Hemodialysis Patients

et al. 2009

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Background. Acquired cystic kidney disease (ACKD) is a frequent complication in chronic hemodialysis (HD) patients and a risk factor for renal cell carcinoma. Online hemodiafiltration (HDF) provides better clearance of middle molecular weight solutes, but its effect on ACKD has not been investigated. Materials and methods. This case-control study enrolled 86 patients (43 HDF patients and 43 HD patients) who were matched according to age, sex, and duration of renal replacement therapy. The mean duration of HDF was 63 (± 35) months. The frequency and severity of ACKD was evaluated by ultrasonography using a severity scoring system. Results. We observed ACKD in 23 of the HD patients (53.5%) and 21 of the HDF patients (48.8%). This difference was not statistically significant (p = 0.829). The overall ACKD severity scores were similar in the two groups (p = 0.875). Patients on HDF had significantly lower serum levels of alkaline phosphatase and intact parathyroid hormone. Multiple logistic regression analysis indicated that duration of renal replacement therapy was the only risk factor for the presence of ACKD (p < 0.001). There was a significant correlation between duration of renal replacement therapy and ACKD severity score (r = 0.589, p < 0.001). Conclusions. Our results suggest that long-term online HDF does not reduce the frequency and severity of ACKD in dialysis patients. Duration of renal replacement therapy is the most important risk factor for ACKD. Factors that cannot be corrected by use of HDF may contribute to the formation of renal cysts.

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Regression of Acquired Cystic Disease of the Kidney after Successful Renal Transplantation

Cited by 114 publications

References 3 publications

Incidence of Acquired Renal Cysts in Biopsy Specimens

Incidence of Acquired Renal Cysts in Biopsy Specimens

Polycystic kidney and renal cell carcinoma in Japanese and Chinese toad hybrids

Long-Term Online Hemodiafiltration Does Not Reduce the Frequency and Severity of Acquired Cystic Kidney Disease in Hemodialysis Patients

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