Nakatsu H, Masai M, Isaka S, Shimazaki J
Department of Urology, School of Medicine, Chiba University, Japan.
Nihon Hinyokika Gakkai Zasshi. 1994 Aug;85(8):1235-42. doi: 10.5980/jpnjurol1989.85.1235.
To examine clinical features and the prognostic factors for renal function in patients with autosomal dominant polycystic kidney disease (ADPKD), a total of 118 patients (60 men and 58 women) were followed for 3 to 192 months (mean 77 months). The mean age of men at the diagnosis of ADPKD was younger than that of women. Main Symptoms were hematuria, hypertension and proteinuria. Forty-one % of the patients showed deterioration of renal function at the diagnosis. The rate of residual volume of renal parenchyma on CT findings was correlated well with renal function. Twenty-eight % of the patients preserved good and stable renal functions for over 5 years, while most of others had deterioration in their renal function. Thirty-four % of the patients started dialysis within 79 +/- 62 months from the diagnosis. The frequency of end stage renal failure was 7% at 40 years, 21% at 50 years, 36% at 60 years and 63% at 70 years old, respectively. Men needed hemodialysis at younger ages than women. Renal function of the patients with hypertension was worse than that of the patients without hypertension. The ratio of the value of P.S.P.120 to that of serum creatinine (PSP120/sCr), and the rate of residual volume of renal parenchyma revealed distinct prognostic factors for renal function.
为研究常染色体显性遗传性多囊肾病（ADPKD）患者的临床特征及肾功能的预后因素，我们对118例患者（60例男性和58例女性）进行了3至192个月（平均77个月）的随访。男性ADPKD患者确诊时的平均年龄低于女性。主要症状为血尿、高血压和蛋白尿。41%的患者在确诊时出现肾功能恶化。CT检查发现的肾实质残余体积率与肾功能密切相关。28%的患者肾功能保持良好且稳定超过5年，而其他大多数患者肾功能出现恶化。34%的患者在确诊后79±62个月内开始透析。40岁时终末期肾衰竭的发生率为7%，50岁时为21%，60岁时为36%，70岁时为63%。男性开始血液透析的年龄比女性小。高血压患者的肾功能比无高血压患者差。酚红排泄试验120分钟值与血清肌酐值之比（PSP120/sCr）以及肾实质残余体积率是肾功能的明显预后因素。
