Sex Differences in Acquired Cystic Disease of the Kidney on Long-Term Dialysis

Ishikawa, Isao; Onouchi, Zengoro; Saito, Yasuhito; Tateishi, Keita; Shinoda, Akira; Suzuki, Shizuko; Kitada, Hirohisa; Sugishita, Naoyasu; Fukuda, Yoshihiro

doi:10.1159/000183401

Cited by 40 publications

(10 citation statements)

References 6 publications

(8 reference statements)

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“…The ratio of male:female was sig nificantly higher in the ESRD population with ARCD compared to the entire ESRD population or the control group (p = 0.02). A similar relationship was documented by Ishikawa et al [27] and Narasimhan et al [8] who noted the prevalence of renal cystic transformation to be 22.4% in males and 2.2% in females with ESRD. The cause for this male predominance among ESRD patients is not clear.…”

Section: Discussionsupporting

confidence: 84%

Acquired Renal Cystic Disease in End-Stage Renal Disease: An Autopsy Study of 155 Cases

Miller¹,

Soffer²,

Nassar³

et al. 1989

Am J Nephrol

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Autopsy reports on 155 successive end-stage renal disease (ESRD) patients and 147 control patients without ESRD, matched for age, race and gender, were collected. Cystic transformation of the kidneys was noted in 58% of the ESRD patients and 13.6% of the control patients. There were 25 ESRD patients with renal adenoma and 3 with renal cell carcinoma. The single best predictor of cystic transformation or tumorous degeneration was patient’s age. A statistically significant association between cystic transformation and gender, as well as the cause of ESRD, was also found. In contrast to previous reports we were unable to document a strong association between the incidence of either cystic transformation or tumorous degeneration with the duration of dialysis, nor did these two parameters correlate with mode of dialysis. We suggest that cystic transformation of the kidneys in ESRD is related to age and renal failure per se, is not strongly associated with duration of dialysis and is independent of mode of dialysis. Concomitant tumorous degeneration was frequent, but this was usually an incidental autopsy finding. Renal malignancy was uncommon and metastases were absent.

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Section: Discussionsupporting

confidence: 84%

Acquired Renal Cystic Disease in End-Stage Renal Disease: An Autopsy Study of 155 Cases

Miller¹,

Soffer²,

Nassar³

et al. 1989

Am J Nephrol

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“…The classification of the cyst grade was slightly modified compared with previous reports [6,11] because the native kidneys of the recipients were severely atrophic and showed few or no cysts [1].…”

Section: Discussionmentioning

confidence: 99%

Cystic Transformation in Native Kidneys in Renal Allograft Recipients with Long-Standing Good Function

Ishikawa

Shikura²,

Shinoda³

1991

Am J Nephrol

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Acquired renal cystic disease develops in the native kidneys of patients with renal allografts with longstanding poor function. However, there has been no long-term prospective study of the regression or development of cysts in native kidneys of renal allograft recipients with good long-term function (serum creatinine: 114 ± 24 µmol/l). We followed 61 renal allograft recipients for 63.5 ± 29.0 months (mean ± SD) using computed tomography (CT scan) every 1 or 2 years after transplantation. The cyst grade at pretransplantation was significantly reduced at the first study after transplantation (0.98 ± 1.39 vs. 0.57 ± 0.96; p < 0.01). Baseline study after transplantation revealed that the incidence of cysts in native kidneys was 22/61 (36.1 %) and 26/61 (42.6%) in the follow-up study. In 32 patients (52.5%), there were no visible cysts in the native kidneys. In 9 patients (14.8%), there was no change in the number of cysts during follow-up, while in another 9 patients the number of cysts decreased. On the other hand, the number of cysts increased in 11 patients (18.0%) during follow-up. The mean follow-up duration was longer in the group with an increased number of cysts than in the groups with no visible cysts or a decrease in number. Biochemical analysis of cyst fluid from newly developed cysts in 2 patients showed differences from the pattern in acquired renal cystic disease of hemodialysis patients. These results indicate that after regression of acquired cysts in most allograft recipients, no or only a few cysts persist in patients with good graft function. The remaining cysts continue to regress further in some patients. On the other hand, the development of new cysts occurs in the native kidneys of some patients (18 %). These newly developed cysts may be different in nature from those of acquired renal cystic disease in hemodialysis patients.

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“…In pa tients with end-stage kidneys who have never been dia lyzed, acquired cysts develop at a rate of 7-22% [13,30]. The severity of cystic transformation has been shown to be greater in males than in females [10,33], not only in studies where males showed a greater preponderance for the disease, but also in those where the prevalence of acquired cysts was similar between the sexes.…”

Section: Acquired Renal Cystic Disease In Patients On Dialysis or Witmentioning

confidence: 99%

“…Male patients tend to develop more extensive cystic changes which can cause unilateral kid ney enlargement to an excess of 1,000 g [5]. On the other hand, females on hemodialysis develop no cysts or, in the case of some elderly patients, few cysts which only rarely cause swelling of the kidney [33]. Figure 1 illustrates the CT scan follow-up in a 22-year-old male on dialysis for chronic glomerulonephritis.…”

Section: Natural History Of Acquired Renal Cystic Diseasementioning

confidence: 99%

“…Resulting kidney enlargement, which is usually seen in male patients, tends to give rise to major complications such as renal cell carcinoma and retroperi toneal bleeding [10], Though the mechanism of acquired cyst development has not yet been elucidated, the uremic milieu seems, at present, to be the most important factor. Sex differences in the severity of cystic changes [33] favor the assumption that endogenous substances are involved in the etiology of acquired cysts. Whatever the case, the relationship between uremic milieu and epithelial hyperplasia war rants detailed investigation in future.…”

Section: Natural History Of Acquired Renal Cystic Diseasementioning

confidence: 99%

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