Eroglu Fehime Kara, Kargın Çakıcı Evrim, Can Gökçe, Güngör Tülin, Yazılıtaş Fatma, Kurt-Sukur Eda Didem, Celikkaya Evra, Üner Çiğdem, Çakmakçı Emin, Bülbül Mehmet
Department of Pediatric Nephrology, Dr Sami Ulus Maternity and Children's Health Hospital, Ankara, Turkey.
Department of Radiology, Dr Sami Ulus Maternity and Children's Health Hospital, Ankara, Turkey.
Pediatr Int. 2018 Dec;60(12):1068-1072. doi: 10.1111/ped.13714.
Increased ultrasonography (US) use has been correlated with an increased incidence of pediatric renal cysts. For simple and stage II cysts, the malignancy risk is low in adulthood, no follow up is recommended; but there is no consensus on childhood management. Given that pediatric renal cysts may be manifestations of hereditary cystic diseases, a different approach and follow up should be taken for these patients. Herein we present the clinical characteristics and follow-up data of pediatric patients with simple and stage II renal cysts.
This cross-sectional study involved 57 children (mean age, 12.44 ± 3.65 years) with simple (n = 35) and stage II cysts (n = 22) who were diagnosed and followed at the present institution for ≥2 years.
The median follow-up period was 2.84 years for simple and 3.10 years for stage II cysts. None of the patients developed complications. No change in cyst diameter was detected in 65.7% of simple or in 45.5% of stage II cysts, whereas 13 simple cysts (37.1%) and eight stage II cysts (36.4%) increased in diameter. The diameter change per year was significantly higher in the stage II cysts than in the simple cysts (P = 0.017). Overall, 13 patients (22%) had an estimated glomerular filtration rate <90 mL/min/1.73 m , and two patients had hypertension.
Although the malignancy risk of simple and stage II kidney cysts is low for this age group, potential complications such as renal dysfunction, hypertension and hereditary cystic disease should be closely monitored.
超声检查(US)使用的增加与小儿肾囊肿发病率的上升相关。对于单纯性囊肿和II期囊肿,成年期的恶性风险较低,不建议进行随访;但对于儿童期的管理尚无共识。鉴于小儿肾囊肿可能是遗传性囊性疾病的表现,应对这些患者采取不同的方法和随访措施。在此,我们介绍了患有单纯性和II期肾囊肿的小儿患者的临床特征和随访数据。
这项横断面研究纳入了57名儿童(平均年龄12.44±3.65岁),他们患有单纯性囊肿(n = 35)和II期囊肿(n = 22),在本机构被诊断并随访≥2年。
单纯性囊肿的中位随访期为2.84年,II期囊肿为3.10年。所有患者均未出现并发症。65.7%的单纯性囊肿和45.5%的II期囊肿未检测到囊肿直径变化,而13个单纯性囊肿(37.1%)和8个II期囊肿(36.4%)直径增大。II期囊肿的每年直径变化显著高于单纯性囊肿(P = 0.017)。总体而言,13名患者(22%)的估计肾小球滤过率<90 mL/min/1.73 m²,2名患者患有高血压。
尽管对于该年龄组,单纯性和II期肾囊肿的恶性风险较低,但仍应密切监测肾功能不全、高血压和遗传性囊性疾病等潜在并发症。