Denton Mark D, Magee Colm C, Ovuworie Cyril, Mauiyyedi Shamila, Pascual Manuel, Colvin Robert B, Cosimi A Benedict, Tolkoff-Rubin Nina
Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Kidney Int. 2002 Jun;61(6):2201-9. doi: 10.1046/j.1523-1755.2002.00374.x.
Acquired renal cystic disease (ARCD), renal adenoma (AD), and renal cell carcinoma (RCC) are more common in patients with end-stage renal disease (ESRD). However, the prevalence of these conditions in patients undergoing transplantation, and the clinical characteristics associated with their occurrence are unclear.
At our institution, the majority of patients undergo an ipsilateral native nephrectomy at the time of transplantation, providing a unique opportunity to study the prevalence and pathology of ARCD, AD and RCC in ESRD. We retrospectively reviewed all consecutive nephrectomy pathology reports over a six year period. Demographic and clinical characteristics associated with these lesions were identified.
Two hundred and sixty nephrectomy reports were reviewed: ARCD, AD, RCC and oncocytoma were found in 33%, 14%, 4.2% and 0.6% of cases, respectively. On multivariable analysis, ARCD was positively associated with male sex and longer dialysis duration and negatively associated with peritoneal dialysis. Similarly, AD was positively associated with male sex, longer dialysis duration and greater age. There was a trend for RCC cases to share similar associations although the small total number of cases precluded findings of statistical significance.
By pathologic analysis, renal tumors are more common in the pre-transplant ESRD population than previously reported (using radiologic methods). Our study also identifies risk factors for their occurrence. This may prove useful in designing screening studies for renal tumors in this patient population.
获得性肾囊肿疾病（ARCD）、肾腺瘤（AD）和肾细胞癌（RCC）在终末期肾病（ESRD）患者中更为常见。然而，这些疾病在接受移植患者中的患病率以及与其发生相关的临床特征尚不清楚。
在我们机构，大多数患者在移植时接受同侧自体肾切除术，这为研究ESRD中ARCD、AD和RCC的患病率及病理提供了独特机会。我们回顾性分析了六年期间所有连续的肾切除病理报告。确定了与这些病变相关的人口统计学和临床特征。
共回顾了260份肾切除报告：分别在33%、14%、4.2%和0.6%的病例中发现了ARCD、AD、RCC和嗜酸细胞瘤。多变量分析显示，ARCD与男性、透析时间延长呈正相关，与腹膜透析呈负相关。同样，AD与男性、透析时间延长和年龄较大呈正相关。RCC病例有类似的相关趋势，尽管病例总数较少，无法得出具有统计学意义的结果。
通过病理分析，移植前ESRD人群中的肾肿瘤比以前报道的（使用放射学方法）更为常见。我们的研究还确定了其发生的危险因素。这可能有助于设计针对该患者群体肾肿瘤的筛查研究。
