De Bono D P, Evans D B
Q J Med. 1977 Jul;46(183):353-63.
The records of 65 patients with adult type polycystic kidney disease were examined in an attempt to identify the problems and priorities in the management of these patients, with particular reference to ultimate haemodialysis or transplantation. The three main problems of patients presenting before the onset of terminal renal failure were hypertension (72 per cent), pain (36 per cent) and urinary tract infection (32 per cent). Less common complications included haematuria, splenomegaly, gastro-intestinal disturbances and disorders of calcium metabolism. The polycystic kidney patient who is considered for renal transplantation poses questions of the desirability and timing of bilateral nephrectomy, vagotomy and splenectomy. Eight patients died without receiving a transplant, five of them from uraemia. Thirty-one patients received 36 kidney transplants and 46 per cent of these were functioning one year after transplantation. Thirteen patients who had received transplants died. Analysis of the causes of death suggests that in nearly half, major contributing factors might have been anticipated and we therefore feel that regular surveillance from the time of diagnosis is essential for patients with polycystic kidney disease.
对65例成人型多囊肾病患者的记录进行了检查，旨在确定这些患者管理中的问题和优先事项，尤其涉及最终的血液透析或移植。终末期肾衰竭出现之前就诊的患者的三个主要问题是高血压（72%）、疼痛（36%）和尿路感染（32%）。较不常见的并发症包括血尿、脾肿大、胃肠道紊乱和钙代谢紊乱。考虑进行肾移植的多囊肾病患者带来了双侧肾切除术、迷走神经切断术和脾切除术的必要性及时机问题。8例患者未接受移植就死亡，其中5例死于尿毒症。31例患者接受了36次肾移植，其中46%在移植后一年仍有功能。13例接受移植的患者死亡。对死亡原因的分析表明，近一半病例的主要促成因素可能是可以预见的，因此我们认为，从诊断之时起进行定期监测对多囊肾病患者至关重要。
