Romano C, Bufano G, Pecchini P, Meroni L, Marenzi C, Gennari S, Croce P, Pecchini F
Divisione di Nefrologia ed Emodialisi, Ospedale di Cremona.
Arch Ital Urol Nefrol Androl. 1991 Jun;63 Suppl 2:61-6.
Acquired bilateral cystic transformation of kidneys in patients on chronic dialysis has been increasingly noted by morphological and clinical studies. Our study aims to identify a group of high-risk patients for incidence and extent of such disease. We studied with ultrasonography 87 patients on maintenance hemodialysis (60 men and 27 women), median age 58 years (range 18 to 81), mean duration of hemodialysis 75 months (range 2-256). The presence of cysts was divided into five grades from 0 no cysts to 4 more than 15 cysts detected for each kidney. 74 patients 85% of our dialytic population had acquired cystic disease; cysts varied in size from 0.5 to 4.5 cm in diameter. The cysts were found in 97% of patients dialyzed for more than 8 years and in 73% of patients on hemodialysis for less than 3 years. The incidence of cystic disease was highly and significantly correlated with the duration of dialysis, the grade correlated with duration of chronic renal failure and hemodialysis. The extent of disease appears to be increased in males. Because of high incidence of disease in long term dialysis patients ultrasonography monitoring is recommended for patients on dialysis for more than 3 years with more attention for males.
形态学和临床研究越来越多地注意到慢性透析患者出现双侧肾囊肿性改变。我们的研究旨在确定一组此类疾病发病率和严重程度的高危患者。我们对87例维持性血液透析患者(60例男性和27例女性)进行了超声检查,中位年龄58岁(范围18至81岁),平均血液透析时间75个月(范围2至256个月)。囊肿的存在分为五个等级,从0级(无囊肿)到4级(每个肾脏检测到超过15个囊肿)。74例患者(占我们透析人群的85%)患有获得性囊肿性疾病;囊肿直径从0.5厘米到4.5厘米不等。在透析超过8年的患者中,97%发现有囊肿,而在血液透析少于3年的患者中,73%发现有囊肿。囊肿性疾病的发病率与透析时间高度显著相关,囊肿等级与慢性肾衰竭和血液透析时间相关。疾病的严重程度在男性中似乎更高。由于长期透析患者中该病的发病率较高,建议对透析超过3年的患者进行超声监测,对男性患者给予更多关注。