Tarantino G, D'Elia F, Brusasco S, Giancaspro V, del Rosso D, Virgilio M
UO di Nefrologia e Dialisi, AUSL BA/2 di Molfetta BA.
Arch Ital Urol Androl. 2000 Dec;72(4):221-4.
Acquired cystic kidney disease (ACKD) is characterized by the substitution of renal parenchyma with multiple cysts in patients either with end stage renal disease who are treated for uremia with dialysis (as on haemodialysis--HD--as on peritoneal dialysis--PD) due to non cystic kidney diseases. The aim of our study was to value the prevalence of ACKD in our haemodialysed patients (with exclusion of polycystic disease and obstructive nephropathy), its relationship between clinical and bioumoral parameters, and its complications in the follow-up. We have studied 56 uremic patients (32f and 24m) on bicarbonate HD three in a week. All our patients underwent renal echography using ECO B mode ALOKA SSD500 with electronic convex sector probe 3.5 MHz for to diagnose ACKD. We divided the population of the study in two groups: the group A includes 23 patients with ACKD; the group B includes 33 patients without ACKD. We analyzed in all patients body mass index (BMI), protein catabolic rate normalized (nPCR), dialitic adequacy index (KT/V), Hb, the serum levels of EPO by ELISA test (MEDAL GmbH, GE, Diagnostika, Hamburg; normal values 5 divided by 30 mUI/ml). We have found a prevalence of 42% for ACKD and statistical significance between the two groups for the duration of HD and BMI (Anova p < 0.01). The EPO serum concentration was higher in the group A (p < 0.05), while their rhuEPO requirement was lower. In two patients of group with ACKD we have found renal carcinoma. In conclusion, by our experience should be opportune to carry out a renal echography at the start of dialysis treatment and every six months for patients with ACKD and every year for those without ACKD. It is necessary to perform the echography of the kidney in all uremic patients before the start of haemo or peritoneal dialysis and report this examination in those patients with ACKD every six months and every year in those without ACKD.
获得性囊性肾病（ACKD）的特征是，因非囊性肾病接受尿毒症透析治疗（如血液透析——HD——或腹膜透析——PD）的终末期肾病患者，其肾实质被多个囊肿替代。我们研究的目的是评估血液透析患者（排除多囊肾病和梗阻性肾病）中ACKD的患病率、其与临床和生物体液参数的关系以及随访中的并发症。我们研究了56例接受每周三次碳酸氢盐HD治疗的尿毒症患者（32例女性和24例男性）。我们所有患者均使用配备3.5 MHz电子凸阵扇形探头的ECO B型ALOKA SSD500进行肾脏超声检查，以诊断ACKD。我们将研究人群分为两组：A组包括23例患有ACKD的患者；B组包括33例未患ACKD的患者。我们分析了所有患者的体重指数（BMI）、标准化蛋白分解率（nPCR）、透析充分性指数（KT/V）、血红蛋白（Hb）、通过ELISA检测（MEDAL GmbH，GE，Diagnostika，汉堡；正常值5至30 mUI/ml）测得的促红细胞生成素（EPO）血清水平。我们发现ACKD的患病率为42%，两组之间在HD持续时间和BMI方面存在统计学意义（方差分析p < 0.01）。A组的EPO血清浓度较高（p < 0.05），而他们对重组人促红细胞生成素（rhuEPO）的需求量较低。在ACKD组的两名患者中我们发现了肾癌。总之，根据我们的经验，在透析治疗开始时对患者进行肾脏超声检查是合适的，对于患有ACKD的患者每六个月进行一次，对于未患ACKD的患者每年进行一次。在血液透析或腹膜透析开始前，有必要对所有尿毒症患者进行肾脏超声检查，并对患有ACKD的患者每六个月报告一次该检查结果，对未患ACKD的患者每年报告一次。
