title: Long-term natural history of acquired cystic disease of the kidney.
abstract: Patients with acquired cystic disease of the kidney (ACDK) were followed longitudinally over an average of 21.7 +/- 5.4 years to determine the natural history of the disease; that is, how big the kidneys become, when the kidney size reaches a plateau, and when the size regresses. Twenty-seven male and 20 female patients with chronic glomerulonephritis treated at our hospital were investigated. CT scans were performed once a year and kidney volume was measured. Two different quadratic curves with a node of 5.2 years for males and 2.5 years for females after the start of hemodialysis were fitted to log-transformed kidney volume to the duration of hemodialysis using a linear mixed model. The maximum kidney volume in male patients was obtained 21.1 years after the start of hemodialysis using this model. Peak values of kidney volume were demonstrated in 19 of 26 cases during the observation period. The median peak value (interquartile range) of bilateral kidney volumes was 274 (165-849) mL/1.73 m(2) occurring 19.1 +/- 4.5 years after the start of dialysis. In one male patient who had undergone nephrectomy due to renal cell carcinoma and in two of the remaining 26 male patients, the maximum kidney volume of 782 (residual kidney), 1151, and 1129 mL regressed to 428, 616, and 847 mL (reduction rate: 45.3, 46.5, and 25.0%) at 20.6, 25.4, and 23.1 years after the start of hemodialysis, respectively. Kidney enlargement due to ACDK reached a plateau after 21.1 years of hemodialysis in the male patients. Partial regression of severe ACDK may occur naturally after long-term hemodialysis without renal transplantation.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Asanogawa General Hospital, Kanazawa, Japan. isikawai@kanazawa-med.ac.jp
authors.forename: Isao
authors.initials: I
authors.lastname: Ishikawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hayama
authors.forename: Kyoko
authors.initials: K
authors.lastname: Morita
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Nakazawa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yokoyama
authors.forename: Ryumon
authors.initials: R
authors.lastname: Honda
authors.forename: Kyoko
authors.initials: K
authors.lastname: Satoh
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Kakuma
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D005921:Glomerulonephritis / Q000150:complications* / Q000628:therapy; D006801:Humans; D052177:Kidney Diseases, Cystic / Q000503:physiopathology* / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D006435:Renal Dialysis; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed