Brendler C B, Albertsen P C, Goldman S M, Hill G S, Lowe F C, Millan J C
J Urol. 1984 Sep;132(3):548-52. doi: 10.1016/s0022-5347(17)49732-1.
A unique form of acquired renal cystic disease occurs commonly in the end stage kidneys of patients with chronic renal failure. Recent experience with 3 cases of acquired renal cystic disease has made us aware that the condition has significant urological implications. The pathogenesis of this disease is unknown but may be related to tubular obstruction, ischemia or the accumulation of toxic products. The diagnosis of acquired renal cystic disease is established by either ultrasound or computerized tomography, both of which demonstrate bilateral multiple small cysts scattered throughout the cortex and medulla of the contracted end stage kidney. Acquired renal cystic disease usually is asymptomatic but may be associated with either hemorrhage or neoplasia. Autopsy studies have revealed renal tumors in up to 45 per cent of the patients with acquired renal cystic disease. These tumors usually are small but our case 3 was a renal cell carcinoma that measured 4 cm. in diameter. Also, there have been other recent reports of large tumors and deaths of metastatic renal carcinoma in patients with acquired renal cystic disease. Patients with chronic renal failure should undergo periodic examination of the native kidneys by either ultrasound or computerized tomography. It may be difficult to distinguish benign from malignant lesions radiologically, and nephrectomy may be indicated when the diagnosis is uncertain.
一种独特形式的获得性肾囊肿病常见于慢性肾衰竭患者的终末期肾脏。近期对3例获得性肾囊肿病的诊治经验使我们认识到，这种病症具有重要的泌尿系统意义。该病的发病机制尚不清楚，但可能与肾小管梗阻、缺血或毒性产物的蓄积有关。获得性肾囊肿病的诊断通过超声或计算机断层扫描来确立，这两种检查均可显示双侧多个小囊肿散布于萎缩的终末期肾脏的皮质和髓质。获得性肾囊肿病通常无症状，但可能伴有出血或肿瘤形成。尸检研究显示，高达45%的获得性肾囊肿病患者存在肾肿瘤。这些肿瘤通常较小，但我们的病例3是一例直径为4厘米的肾细胞癌。此外，近期还有其他报道称，获得性肾囊肿病患者出现了大肿瘤以及转移性肾癌导致的死亡。慢性肾衰竭患者应定期通过超声或计算机断层扫描对原肾进行检查。从影像学上可能难以区分良性与恶性病变，当诊断不确定时可能需要进行肾切除术。
