1
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Sekine A, Hidaka S, Moriyama T, Shikida Y, Shimazu K, Ishikawa E, Uchiyama K, Kataoka H, Kawano H, Kurashige M, Sato M, Suwabe T, Nakatani S, Otsuka T, Kai H, Katayama K, Makabe S, Manabe S, Shimabukuro W, Nakanishi K, Nishio S, Hattanda F, Hanaoka K, Miura K, Hayashi H, Hoshino J, Tsuchiya K, Mochizuki T, Horie S, Narita I, Muto S. Cystic Kidney Diseases That Require a Differential Diagnosis from Autosomal Dominant Polycystic Kidney Disease (ADPKD). J Clin Med 2022; 11:6528. [PMID: 36362756 PMCID: PMC9657046 DOI: 10.3390/jcm11216528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/14/2022] [Accepted: 11/01/2022] [Indexed: 09/05/2023] Open
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary cystic kidney disease, with patients often having a positive family history that is characterized by a similar phenotype. However, in atypical cases, particularly those in which family history is unclear, a differential diagnosis between ADPKD and other cystic kidney diseases is important. When diagnosing ADPKD, cystic kidney diseases that can easily be excluded using clinical information include: multiple simple renal cysts, acquired cystic kidney disease (ACKD), multilocular renal cyst/multilocular cystic nephroma/polycystic nephroma, multicystic kidney/multicystic dysplastic kidney (MCDK), and unilateral renal cystic disease (URCD). However, there are other cystic kidney diseases that usually require genetic testing, or another means of supplementing clinical information to enable a differential diagnosis of ADPKD. These include autosomal recessive polycystic kidney disease (ARPKD), autosomal dominant tubulointerstitial kidney disease (ADTKD), nephronophthisis (NPH), oral-facial-digital (OFD) syndrome type 1, and neoplastic cystic kidney disease, such as tuberous sclerosis (TSC) and Von Hippel-Lindau (VHL) syndrome. To help physicians evaluate cystic kidney diseases, this article provides a review of cystic kidney diseases for which a differential diagnosis is required for ADPKD.
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Affiliation(s)
- Akinari Sekine
- Nephrology Center, Toranomon Hospital, Tokyo 105-8470, Japan
| | - Sumi Hidaka
- Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kanagawa 247-8533, Japan
| | - Tomofumi Moriyama
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Fukuoka 830-0011, Japan
| | - Yasuto Shikida
- Department of Nephrology, Saiseikai Nakatsu Hospital, Osaka 530-0012, Japan
| | - Keiji Shimazu
- Department of Nephrology, Saiseikai Nakatsu Hospital, Osaka 530-0012, Japan
| | - Eiji Ishikawa
- Department of Nephrology, Saiseikai Matsusaka General Hospital, Mie 515-8557, Japan
| | - Kiyotaka Uchiyama
- Department of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Hiroshi Kataoka
- Department of Nephrology, Tokyo Women’s Medical University, Tokyo 162-8666, Japan
| | - Haruna Kawano
- Department of Urology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
- Department of Advanced Informatics for Genetic Disease, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
| | - Mahiro Kurashige
- Division of Kidney and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Mai Sato
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo 157-8535, Japan
| | - Tatsuya Suwabe
- Nephrology Center, Toranomon Hospital, Tokyo 105-8470, Japan
| | - Shinya Nakatani
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Tadashi Otsuka
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan
| | - Hirayasu Kai
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan
| | - Kan Katayama
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Mie 514-8507, Japan
| | - Shiho Makabe
- Department of Nephrology, Tokyo Women’s Medical University, Tokyo 162-8666, Japan
| | - Shun Manabe
- Department of Nephrology, Tokyo Women’s Medical University, Tokyo 162-8666, Japan
| | - Wataru Shimabukuro
- Department of Child Health and Welfare (Pediatrics), Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan
| | - Koichi Nakanishi
- Department of Child Health and Welfare (Pediatrics), Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan
| | - Saori Nishio
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Fumihiko Hattanda
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Kazushige Hanaoka
- Department of General Internal Medicine, Daisan Hospital, Jikei University, School of Medicine, Tokyo 105-8471, Japan
| | - Kenichiro Miura
- Department of Pediatric Nephrology, Tokyo Women’s Medical University, Tokyo 162-8666, Japan
| | - Hiroki Hayashi
- Department of Nephrology, Fujita Health University, Aichi 470-1192, Japan
| | - Junichi Hoshino
- Department of Nephrology, Tokyo Women’s Medical University, Tokyo 162-8666, Japan
| | - Ken Tsuchiya
- Department of Blood Purification, Tokyo Women’s Medical University, Tokyo 162-8666, Japan
| | | | - Shigeo Horie
- Department of Urology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
- Department of Advanced Informatics for Genetic Disease, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
| | - Ichiei Narita
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan
| | - Satoru Muto
- Department of Urology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
- Department of Urology, Juntendo University Nerima Hospital, Tokyo 177-8521, Japan
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2
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Salupo NW, Grant M, Patel S. Unilateral Cystic Kidney Disease in a Young Female. Cureus 2022; 14:e24719. [PMID: 35673317 PMCID: PMC9164525 DOI: 10.7759/cureus.24719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2022] [Indexed: 11/13/2022] Open
Abstract
Unilateral renal cystic disease has been mostly reported in older male patients; however, this case is novel as the youngest reported case in the literature and in a female patient. We present a 22-year-old female with no past medical history and no family history of renal disease that was incidentally found to have unilateral renal cystic disease on computed tomography imaging. The patient’s renal function was not impaired and the cystic kidney was found to be functioning appropriately on an intravenous pyelogram. The unilateral cystic disease is benign but must be differentiated from autosomal dominant polycystic disease to prevent morbidity and mortality.
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3
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Hoang VT, Hoang TH, Nguyen TTT, Trinh CT, Chansomphou V, Hoang DT. Traumatic Kidney in a Patient With Unilateral Renal Cystic Disease. J Investig Med High Impact Case Rep 2022; 10:23247096221089495. [PMID: 35382616 PMCID: PMC8990544 DOI: 10.1177/23247096221089495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Renal trauma occurring in patients with unilateral renal cystic disease (URCD) is
extremely rare. Unilateral renal cystic disease is benign, nonprogressive, nonfamilial,
nonencapsulated, and unrelated to cysts in other organs. It should be differentiated from
autosomal dominant polycystic kidney disease (ADPKD) parenthesis, multicystic dysplastic
kidney disease, multiple renal simple cysts, and cystic renal neoplasms. We report a case
of a 15-year-old male with URCD admitted to the hospital sustaining blunt trauma to his
right flank after a motor vehicle crash. Final diagnosis in this case was renal injury in
a URCD patient. The patient was treated conservatively and subsequently discharged.
Unilateral renal cystic disease can be diagnosed and followed by a combination of imaging
methods and functional studies. The management of URCD is conservative. Although the
disease is stable, nephrectomy may occasionally be indicated when there is a strong
suspicion for malignancy.
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Affiliation(s)
| | | | | | | | | | - Duc Thanh Hoang
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Walter Reed National Military Medical Center, Bethesda, MD, USA
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4
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Shin C, Berliner L. Case report: Atypical polycystic kidney disease. Radiol Case Rep 2021; 16:1643-1645. [PMID: 34007375 PMCID: PMC8111457 DOI: 10.1016/j.radcr.2021.03.068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/28/2021] [Accepted: 03/29/2021] [Indexed: 11/17/2022] Open
Abstract
Atypical or unilateral polycystic kidney disease is a rare entity that is found incidentally and is characterized on imaging as asymmetric or unilateral distribution of cysts confined to the kidneys. We present a case of an incidental finding of atypical polycystic kidney disease in a 72-year-old male. Computed tomography imaging showed asymmetric distribution of cysts only in the kidneys and the patient had no genitourinary symptoms, had normal renal function, and did not have a family history of renal disease. Although considered to be benign, rare cases of progression of atypical polycystic kidney disease to bilateral polycystic kidney disease has been documented in the literature, which portends a worse prognosis. It is important for clinicians to be aware of this entity so that patients can be monitored periodically for progression of disease.
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Unilateral autosomal dominant polycystic kidney disease with co-existent renal cell carcinoma: A rare entity. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2018. [DOI: 10.1016/j.ejrnm.2017.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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6
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A case of unilateral nephrectomy performed for autosomal dominant polycystic kidney disease with marked unilateral enlargement. CEN Case Rep 2018; 7:143-147. [PMID: 29388169 DOI: 10.1007/s13730-018-0312-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 01/23/2018] [Indexed: 10/18/2022] Open
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is characterized by the occurrence of multiple cysts that increase the size of both kidneys, progressively reducing kidney function. Usually the cysts occur bilaterally, and there is no difference in the degree of cyst enlargement between the left and right. Here, we report a case of ADPKD in which kidney size increased markedly on the left side and was accompanied by severe abdominal distension and discomfort. Renal dynamic scintigraphy revealed a severe reduction in function of the left kidney compared with the right. Open left nephrectomy was performed. No change in renal function was observed postoperatively [preoperative estimated glomerular filtration rate (eGFR): 57.6 mL/min/1.73 m2, 3-month postoperative eGFR: 56.4 mL/min/1.73 m2], and the abdominal symptoms subsided. When one kidney is markedly larger than the other, the cause and status of the laterality should be evaluated by using renal dynamic scintigraphy in addition to other examinations such as computed tomography or magnetic resonance imaging. Unilateral nephrectomy should be considered as a potential treatment.
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7
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Dimala CA, Bechem NN, Kadia BM, Feteh VF, Choukem SP. Diagnostic and therapeutic challenges of an ambiguous cystic kidney disease in a resource limited setting: a case report. BMC Res Notes 2017; 10:114. [PMID: 28249589 PMCID: PMC5333378 DOI: 10.1186/s13104-017-2437-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 02/24/2017] [Indexed: 12/03/2022] Open
Abstract
Background Unilateral renal cystic disease is a rare condition that shares morphological similarities with multicystic dysplastic kidney, the former often distinguished from the latter on some clinical and histopathological grounds. However serious diagnostic and therapeutic dilemmas set in when there is a considerable overlap in the distinguishing features between these entities. Case presentation A 19-year-old African female presented with a chronic severe debilitating right lower quadrant abdominal pain refractory to analgesics. Biochemical investigations and imaging studies revealed a non-functional polycystic right kidney and no identifiable pelvicalyceal system or ureter but with preserved renal function. The marked overlap in clinical presentation between unilateral renal cystic disease and multicystic dysplastic kidney in this patient necessitated further investigation to pose an appropriate diagnosis. A right nephrectomy was performed and histopathological analysis of the resected kidney done, the results of which were more consistent with unilateral renal cystic disease. The post-operative course was favorable. Conclusion Unilateral renal cystic disease with an ipsilateral non-functional kidney and an atretic pelvicalyceal system is a very rare condition that needs to be distinguished from multicystic dysplastic kidney in order to guide management and set prognosis. A suspicion of either of these diseases therefore warrants a thorough clinical evaluation and the appropriate combination of biochemical and imaging investigations.
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Affiliation(s)
- Christian Akem Dimala
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. .,Orthopaedics Department, Southend University Hospital, Essex, UK. .,Health and Human Development (2HD) Research Group, Douala, Cameroon.
| | | | | | - Vitalis Fambombi Feteh
- Health and Human Development (2HD) Research Group, Douala, Cameroon.,Mboppi Baptist Hospital, Douala, Cameroon
| | - Simeon Pierre Choukem
- Health and Human Development (2HD) Research Group, Douala, Cameroon.,Faculty of Health Sciences, University of Buea, Buea, Cameroon.,Douala General Hospital, Douala, Cameroon
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8
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Behr CA, Hesketh AJ, Williamson AK, Soffer SZ, Glick RD. Localized cystic disease of the kidney: A rare diagnosis of this uncommon condition in a child. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2016. [DOI: 10.1016/j.epsc.2016.06.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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9
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Unilateral renal cystic disease in the left kidney. Clin Exp Nephrol 2016; 20:822. [PMID: 26857565 DOI: 10.1007/s10157-016-1242-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 01/31/2016] [Indexed: 10/22/2022]
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10
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Katabathina VS, Vinu-Nair S, Gangadhar K, Prasad SR. Update on adult renal cystic diseases. APPLIED RADIOLOGY 2015. [DOI: 10.37549/ar2229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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11
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Bae EH, Hwang YH, Kim SW. Unilateral renal cystic disease in the right kidney. Int Braz J Urol 2013; 39:435-7. [PMID: 23849577 DOI: 10.1590/s1677-5538.ibju.2013.03.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 03/12/2013] [Indexed: 11/22/2022] Open
Affiliation(s)
- Eun Hui Bae
- Departments of Internal Medicine, Chonnam National University Medical School, Gwangju, and Department of Internal Medicine, Eulji General Hospital, Seoul, Korea
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12
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13
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Abstract
Localized cystic disease of the kidney is a benign nonsurgical entity and presents with multiple cystic lesions in just one portion of the kidney or involves the entire one kidney. We report a case of localized cystic disease of the kidney in a 16 year-old-male. This patient underwent an ultrasound examination and incidentally found to have multiple cysts in the right kidney whereas the left kidney was normal. Diagnosis was confirmed by typical MRI findings, absence of any family history, normal results of urine analysis and renal function tests.
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Affiliation(s)
- Zafar Neyaz
- Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
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14
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Thuesen AD, Steffensen GK. Polycythaemia treated with nephrectomy. NDT Plus 2011; 4:246-7. [PMID: 25949492 PMCID: PMC4421443 DOI: 10.1093/ndtplus/sfr066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 05/02/2011] [Indexed: 11/15/2022] Open
Abstract
Unilateral renal cystic disease (URCD) is a rare, non-familial non-progressive renal disorder not associated with cysts in other organs in contrast to autosomal dominant polycystic kidney disease. Only 55 cases have been published in the world literature. Renal diseases are a well-recognized etiology of secondary erythrocytosis but not in URCD. We can present at case of URCD and secondary polycythaemia. Only one case with similar history has been reported, but in our case, the polycythaemia was confirmed by measuring the erythropoietin (EPO) level in the cyst fluid.
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15
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Miyamoto Y, Nagai M, Hirayama K, Shimohata H, Kobayashi M. Non-hereditary multiple renal cysts in unilateral kidney. Clin Kidney J 2011; 4:73-4. [PMID: 25984110 PMCID: PMC4421641 DOI: 10.1093/ndtplus/sfq189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 10/12/2010] [Accepted: 10/13/2010] [Indexed: 11/25/2022] Open
Affiliation(s)
- Yasunori Miyamoto
- Department of Nephrology , Tokyo Medical University Ibaraki Medical Center , Ami, Ibaraki , Japan
| | - Miho Nagai
- Department of Nephrology , Tokyo Medical University Ibaraki Medical Center , Ami, Ibaraki , Japan
| | - Kouichi Hirayama
- Department of Nephrology , Tokyo Medical University Ibaraki Medical Center , Ami, Ibaraki , Japan
| | - Homare Shimohata
- Department of Nephrology , Tokyo Medical University Ibaraki Medical Center , Ami, Ibaraki , Japan
| | - Masaki Kobayashi
- Department of Nephrology , Tokyo Medical University Ibaraki Medical Center , Ami, Ibaraki , Japan
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16
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Affiliation(s)
- N A Choh
- Department of Radiodiagnosis, Govt Medical College, Srinagar, India
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17
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Reed B, Nobakht E, Dadgar S, Bekheirnia MR, Masoumi A, Belibi F, Yan XD, Cadnapaphornchai M, Schrier RW. Renal ultrasonographic evaluation in children at risk of autosomal dominant polycystic kidney disease. Am J Kidney Dis 2010; 56:50-6. [PMID: 20452711 DOI: 10.1053/j.ajkd.2010.02.349] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2009] [Accepted: 02/25/2010] [Indexed: 11/11/2022]
Abstract
BACKGROUND To date, there are no criteria for diagnosing autosomal dominant polycystic kidney disease (ADPKD) in at-risk children 15 years or younger. STUDY DESIGN Longitudinal (retrospective cohort study). SETTING & PARTICIPANTS 420 children (mean age, 8.3 +/- 4.2 years) with a family history of ADPKD were studied. MEASUREMENTS Renal ultrasonography was performed for cyst detection. Urine protein was measured using two 24-hour urine collections. Glomerular filtration rate was calculated using the Schwartz formula. Blood pressure measurements were performed in the arm with the highest blood pressure, using an appropriate cuff size. Standard 2-dimensional and Doppler echocardiography was performed for measuring left ventricular mass index. PREDICTORS None. OUTCOME Presence of renal cysts. RESULTS Renal cysts were detected in 193 children and no cysts were detected in 227 children. In children with renal cysts, 150 had bilateral and 43 had unilateral cysts. Children with bilateral cysts had larger kidneys and more hypertension than children with unilateral or no cysts. Follow-up in 77 children 15 years or younger showed bilateral cysts in 14 and unilateral cysts in 4 of the children who had no detectable renal cysts using ultrasonography at baseline. Similar follow-up of 26 children 15 years or younger with unilateral cysts detected at baseline showed bilateral cysts in 17 children using ultrasonography. By 15 years of age, 181 patients in the total group of 420 showed bilateral cysts. Overall, 193 of 304 children (63.4%) who had follow-up at any age developed bilateral cysts detected using ultrasonography. LIMITATIONS Follow-up unavailable for all participants. CONCLUSION The present results in 420 at-risk children with ADPKD 15 years or younger detected bilateral renal cysts using ultrasonography in 181 of the children who had a family history of this genetic disease.
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Affiliation(s)
- Berenice Reed
- Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, CO, USA
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18
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Poster D, Kistler AD, Krauer F, Blumenfeld JD, Rennert H, Weishaupt D, Wüthrich RP, Serra AL. Kidney Function and Volume Progression in Unilateral Autosomal Dominant Polycystic Kidney Disease With Contralateral Renal Agenesis or Hypoplasia: A Case Series. Am J Kidney Dis 2009; 54:450-8. [PMID: 19515475 DOI: 10.1053/j.ajkd.2009.03.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2008] [Accepted: 03/11/2009] [Indexed: 11/11/2022]
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19
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Sirvent AE, Enríquez R, Ardoy F, Amorós F, González C, Reyes A. Autosomal dominant polycystic kidney disease with congenital absence of contralateral kidney. Int Urol Nephrol 2007; 38:773-4. [PMID: 17171426 DOI: 10.1007/s11255-006-0032-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Autosomal dominant polycystic kidney disease is the most frequent hereditary kidney disorder, accounting for 8-10% of the cases of end-stage renal disease. It is characterized by bilateral multiple renal cysts, nevertheless, asymmetric enlargement of the kidneys is frequently observed, and this can lead to diagnostic confusion. We report the rare occurrence of autosomal dominant polycystic disease confined to a right kidney and congenital absence of the contralateral one. Unexpected early onset of terminal renal failure in this hypertensive 23-year-old male is discussed with the review of the literature.
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Affiliation(s)
- A E Sirvent
- Nephrology Section, Hospital General Universitario de Elche, Camí de l' Almazara s/n, 03203, Elche, Alicante, Spain.
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20
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Affiliation(s)
- Bum Soo Park
- Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Tae-Hwan Kim
- Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Sung-Jig Lim
- Department of Pathology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Hyung-Lae Lee
- Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Seung Hyun Jeon
- Department of Urology, School of Medicine, Kyung Hee University, Seoul, Korea
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21
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Abstract
This review aims to assist in the categorization of inherited, developmental, and acquired cystic disease of the kidney as well as to provide a pertinent, up-to-date bibliography. The conditions included are autosomal-dominant polycystic kidney disease, autosomal-recessive polycystic kidney disease, unilateral renal cystic disease (localized cystic disease), renal simple cysts, multicystic dysplastic kidney, pluricystic kidney of the multiple malformation syndromes, juvenile nephronophthisis and medullary cystic disease, medullary sponge kidney, primary glomerulocystic kidney disease, and glomerulocystic kidney associated with several systemic disorders mainly of genetic or chromosomal etiology, cystic kidney in tuberous sclerosis, and in von Hippel-Lindau syndrome, cystic nephroma, cystic variant of congenital mesoblastic nephroma, mixed epithelial stromal tumor of the kidney, renal lymphangioma, pyelocalyceal cyst, peripylic cyst and perinephric pseudocyst, acquired renal cystic disease of long-term dialysis, and cystic renal cell carcinoma and sarcoma. Whereas the gross and histologic appearance of some of these conditions may be diagnostic, clinical and sometimes molecular studies may be necessary to define other types.
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Affiliation(s)
- Michele Bisceglia
- Division of Anatomic Pathology, IRCCS Casa Sollievo della Sofferenza Hospital, I-71013 San Giovanni Rotondo (FG), Italy.
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22
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Ng YY, Shen SH, Huang WJS. CHRONIC PYONEPHROSIS WITH POLYCYSTIC CHANGE. Nephrology (Carlton) 2005; 10:422-3. [PMID: 16109094 DOI: 10.1111/j.1440-1797.2005.00411.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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23
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Affiliation(s)
- Michele Bisceglia
- Division of Anatomic Pathology, Department of Pathology, IRCCS-Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.
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24
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Abstract
Unilateral and segmental cystic disease is a rare cystic disease of the kidney. Except for its unilaterality, it resembles autosomal dominant polycystic kidney disease on gross and histological examination. It also lacks genetic background and progressive deterioration of renal function. Only a small number of unilateral and segmental cystic disease of the kidney cases have been reported to date. The present case is a report of a 69-year-old man who had a large multicystic mass involving the lower and middle part of the right kidney with normal residual renal parenchyma at the upper pole. The left kidney was entirely normal. All the laboratory tests were within normal limits. Right nephrectomy was performed because of a strong suspicion of malignancy.
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Affiliation(s)
- R P S Punia
- Department of Pathology and Surgery, Government Medical College and Hospital, Chandigarh, India
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25
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Abstract
Unilateral renal cystic disease (URCD) is a distinct entity that is one of the renal cystic diseases. The clinical importance of URCD is to make a differential diagnosis from autosomal dominant polycystic kidney disease (ADPKD), multicystic dysplastic kidney, multilocular cystic renal neoplasm, and simple cysts. To confirm the diagnosis and to rule out asynchronous ADPKD requires long-term follow up, especially in younger patients.
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Affiliation(s)
- Sik Lee
- Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine, Jeonju, South Korea
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26
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Abstract
We present a patient with an apparent renal mass that was identified antenatally with pyelocaliectasis and ureterectasis. A right ectopic ureter with an apparent cystic upper pole was eventually confirmed at 5 months of age. The definitive diagnosis in this case eluded an initial exhaustive neonatal radiologic and surgical evaluation.
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MESH Headings
- Abnormalities, Multiple/diagnostic imaging
- Abnormalities, Multiple/embryology
- Adult
- Biopsy
- Diagnosis, Differential
- Female
- Fetal Diseases/diagnostic imaging
- Humans
- Hydronephrosis/diagnostic imaging
- Hydronephrosis/embryology
- Infant, Newborn
- Kidney Neoplasms/diagnosis
- Kidney Tubules, Collecting/abnormalities
- Kidney Tubules, Collecting/embryology
- Nephroma, Mesoblastic/diagnosis
- Polycystic Kidney, Autosomal Dominant/diagnosis
- Polycystic Kidney, Autosomal Dominant/embryology
- Polycystic Kidney, Autosomal Dominant/pathology
- Pregnancy
- Ultrasonography, Prenatal
- Ureter/abnormalities
- Ureter/embryology
- Wilms Tumor/diagnosis
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Affiliation(s)
- C D Anthony Herndon
- Department of Urology, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Abstract
OBJECTIVE Localized cystic disease of the kidney is a benign nonsurgical condition. Its imaging and clinical features are characterized and differentiated from autosomal dominant polycystic kidney disease, multilocular cystic nephroma, and cystic neoplasm. MATERIALS AND METHODS Localized cystic disease was diagnosed in 18 patients on the basis of a review of imaging studies, clinical histories, and pathologic proof in four of the 18 patients. Average age at diagnosis was 54 years (age range, 24-83 years). Fifteen of the patients (83%) were men. CT was performed on 18 patients, sonography on nine, excretory urography on six, arteriography on four, and MR imaging on two. RESULTS Localized cystic disease was unilateral in all patients and characterized by multiple cysts of various sizes separated by normal (or atrophic) renal tissue in a conglomerate mass suggestive of cystic neoplasm. In some patients, involvement of the entire kidney, which was suggestive of unilateral autosomal dominant polycystic kidney disease, was seen. No cysts were seen in the contralateral kidney in 14 patients, and only one or two scattered small cysts were present in four patients. Clinical presentations included hematuria, flank pain, palpable abdominal mass, and localized cystic disease as an incidental finding. None of the patients had a family history of autosomal dominant polycystic kidney disease. Ten patients underwent follow-up (follow-up range, 1-12 years); nine patients underwent imaging follow-up and one patient underwent clinical follow-up, which showed stability of disease. Four patients underwent nephrectomy for suspected renal neoplasm. CONCLUSION Familiarity with localized cystic disease of the kidney and its imaging findings is important to avoid unnecessary surgery and to differentiate the disease from autosomal dominant polycystic kidney disease.
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Affiliation(s)
- C M Slywotzky
- Department of Radiology, New York University Medical Center, Tisch HW 202, 560 First Ave., New York, NY 10016, USA
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28
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Todorov VV. The diagnostic dilemma of the unilateral cystic kidney-ADPKD with aplasia of one kidney. Nephrol Dial Transplant 1999; 14:2775. [PMID: 10534805 DOI: 10.1093/ndt/14.11.2775] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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