Krempien B, Ritz E
Virchows Arch A Pathol Anat Histol. 1980;386(2):189-200. doi: 10.1007/BF00427230.
In the present study, the kidneys of patients who had been on maintenance haemodialysis for variable periods of time were examined at autopsy. In 21 of the 22 patients, multiple pinhead-size to pea-size, non-loculated cysts were observed both in the cortex and the medulla. In some of the cysts (4/20 patients), papillary adenomata were observed which were visible by light microscopy in 3 cases and macroscopically in 1 case. Clinical complications resulting from haemorrhage or neoplastic transformation were not observed in any of the patients of this series. Similar cysts, smaller in size and fewer in number, were also observed in kidneys of uraemic patients who had not been dialysed. Thus, the lesion does not appear to be a specific consequence of maintenance haemodialysis. It appears more likely that extensive cystic transformation of the kidneys of patients in terminal renal failure is made possible by prolonged survival on maintenance haemodialysis. The possibility of malignant transformation of the papillomata cannot be refuted, but epidemiological surveys fail to document more frequent occurrence of renal carcinoma in dialysed patients.
在本研究中，对接受维持性血液透析不同时长的患者的肾脏进行了尸检。22例患者中有21例，在皮质和髓质均观察到多个针头大小至豌豆大小的非分隔性囊肿。在部分囊肿中（20例患者中的4例），观察到乳头状腺瘤，其中3例通过光学显微镜可见，1例肉眼可见。该系列患者中未观察到因出血或肿瘤转化导致的临床并发症。在未接受透析的尿毒症患者的肾脏中也观察到了类似的囊肿，只是尺寸更小、数量更少。因此，该病变似乎并非维持性血液透析的特定后果。终末期肾衰竭患者肾脏广泛的囊性转变更有可能是由于维持性血液透析延长了生存期所致。乳头状瘤恶变的可能性无法排除，但流行病学调查未能证明透析患者中肾癌的发生率更高。
