Renal excretion and cyst accumulation of beta 2microglobulin in polycystic kidney disease

To determine the extent to which proximal tubule function is altered beta 2microglobulin (beta 2m), creatinine and Na were measured in serum, urine and cyst fluid of patients with autosomal dominant polycystic kidney disease and various degrees of renal insufficiency. Fractional excretion (FE beta 2m) was 0.11 +/- 0.03% in six normal subjects and 0.13 +/- 0.05% in nine patients with serum creatinine levels less than 1.6 mg/dl. In five patients with serum creatinine levels above 3.0 mg/dl, FE beta 2m was elevated (range 3.5 to 196%) and serum levels were higher than normal (30,600 +/- 6,910 micrograms/liter vs. 1,268 +/- 111). In seven patients beta 2m levels in 33 proximal cysts (cyst/serum Na greater than 0.8) equalled those in serum (cyst/serum beta 2m 0.98 +/- 0.20), whereas in 21 distal cysts (cyst/serum Na less than 0.4) beta 2m was less than in serum (cyst/serum beta 2m 0.17 +/- 0.07). Analysis of fluid in two patients with polycystic kidney nephrectomy several weeks posttransplant indicated that proximal cyst epithelium is permeable to beta 2m, but less so than to creatinine or urea. These studies show that proximal cysts cannot develop or maintain gradients for beta 2m, whereas distal cysts maintain low levels of the protein despite end-stage renal failure. The normal FE beta 2m values in nonazotemic autosomal dominant polycystic kidney disease patients and the low distal cyst levels of beta 2m in end-stage kidneys indicate that the cystic proximal nephrons do not contribute appreciably to the final urine.(ABSTRACT TRUNCATED AT 250 WORDS)     

Incidence of acquired renal cysts in biopsy specimens

AIMS: This study investigated whether or not acquired renal cysts develop in patients with mild chronic renal failure. METHODS: A retrospective study was carried out using renal biopsy specimens from 720 patients. A renal cyst was defined as a tubule dilated >200 microm. RESULTS: Renal cysts were found in 21 of 720 renal biopsy specimens. Serum creatinine of 21 patients with renal cysts was significantly higher than that of 699 patients without cysts (2.59 +/- 2.64 vs. 1.09 +/- 0.79 mg/dl) (p < 0.0001). Poor renal function (serum creatinine >1.6 mg/dl) reveals more cyst formation on biopsy specimens than good renal function (serum creatinine <1.5 mg/dl). Cysts were observed in 11 of 607 (1.8%) patients less than 50 years of age and in 10 of 113 (8.8%) patients over 51 years. To exclude simple cysts which are commonly observed in older subjects, 11 patients under 50 years of age were extensively examined. Mean serum creatinine was 2.98 +/- 3.06 mg/dl (0.7-10.4 mg/dl). These 11 patients revealed low creatinine clearance of 47.5 +/- 25.6 ml/min (5-71 ml/min). Creatinine clearances in 7 patients were 52-71 ml/min (serum creatinine 0.7-2.0 mg/ dl). One of 11 biopsy specimens with cysts was examined by immunohistochemistry on lectin. This specimen was positive for tetragonolobus lectin and negative for peanut lectin, suggesting that the epithelial cells lining the cyst were derived from proximal tubules, unlike those of simple cysts. CONCLUSION: These results suggest that low normal renal function such as creatinine clearances 52-71 ml/min due to nephron loss is sufficient to induce acquired cyst development in various renal diseases.     

A new treatment of simple renal cyst: percutaneous instillation of minocycline hydrochloride into simple renal cyst

Minocycline hydrochloride was percutaneously instilled into simple renal cysts to prevent recurrence of renal cysts after the puncture and aspiration of cystic fluid. Fifty-six simple renal cysts in 51 patients were punctured with an 18-gauge needle under ultrasonographic guidance, and the cystic fluid was aspirated under fluoroscopic control. A single 100 mg or 200 mg dose of minocycline hydrochloride dissolved in 5 ml of distilled water was instilled through the needle into the renal cyst. The patients were followed up by computed tomographic (CT) scan and ultrasonography 1, 3, 6 and 12 months after the treatment. Efficacy was evaluated after 3 months or longer. Of 20 renal cysts instilled with 100 mg of minocycline, efficacy was excellent in 10, good in 6 and poor in 4. Of 22 renal cysts instilled with 200 mg of minocycline, efficacy was excellent in 10, good in 9 and poor in 3. No significant difference was noted between the efficacy rate of 100 mg and 200 mg treatments. Complications attributable to treatment were observed in 15 patients: moderate pain in one, slight pain in 6, slight fever in 8 and slight hematuria in one. Neither severe adverse reactions nor infections were observed in any of the patients. These results suggest that the percutaneous instillation of minocycline into simple renal cysts is a new, simple, safe and effective treatment to prevent recurrence of the cyst and additionally to prevent infection following the puncture.     

Adult vallecular cyst: thirteen-year experience.

OBJECTIVE: To assess the characteristics of adult vallecular cyst. STUDY DESIGN AND SETTINGS: A retrospective chart review from a university affiliated hospital. SUBJECTS AND METHODS: Clinical manifestations and airway management of 38 consecutive adult patients with vallecular cyst admitted between 1992 and 2004 were studied. RESULTS: Two distinct groups were identified: infected (n = 24) and noninfected (n = 14). Twenty-two (91.7%) patients of the former group had acute epiglottitis with an abrupt onset culminating in abscess formation in 19 (79.2%) and airway compromise in 9 (37.5%) compared with none in the noninfected group (P = 0.006). In 4 (18.2%) of 22 patients, the origin of the infected vallecular cyst was evident only after symptoms subsided. Three patients had recurrent acute epiglottitis. The noninfected group had a relatively prolonged mild clinical course. CONCLUSIONS: Two types of vallecular cysts were characterized. Abscess formation was the hallmark of adult infected vallecular cyst. SIGNIFICANCE: To improve patient care, endoscopic follow-up is advocated. In patients with recurrent episodes of acute epiglottitis, imaging is recommended.     

Features of computed tomography in hydatid cysts of the urinary tract

The features of computed tomography (CT) in 5 patients with hydatid disease of the urinary tract are described. The diagnosis of hydatid disease was based on the demonstration of unilocular or multilocular cysts with well defined walls which enhanced with contrast, which were often calcified and which contained daughter cysts within the large parent cyst. It is difficult to differentiate between a unilocular hydatid cyst without mural calcification and an infected simple renal cyst.     

单纯性肾囊肿应用不同术式治疗的效果比较

目的 探讨并分析单纯性肾囊肿应用不同术式治疗的效果比较.方法 选取本院于2014年6月至2016年7月期间收治的单纯性肾囊肿108例,将所有患者按照随机数字表法分为试验组和对照组两组;试验组50例患者行经皮肾穿刺并无水酒精硬化(PAES)术,对照组58例患者行腹腔镜肾囊肿去顶术.采集患者术后恢复状况、手术疗效以及所花费用等资料,并进行统计分析对比.结果 患者年龄、性别、肾囊肿部位、肾囊肿分型等资料比较差异无统计学意义(P＞0.05).两组患者的并发症发生率与手术治愈率与所选治疗方式无明显关联,差异比较无统计学意义(P＞0.05).两组患者的手术用时、治疗所花费用、手术后住院时间与所选治疗方式有一定关联结果,差异比较具有统计学意义(P＜0.05).术后随访两组患者12个月,其中试验组所吸出囊液平均量(135±17.9)mL,注入所需99％无水酒精平均量(34 ±6.4) mL;所有患者抽出囊液颜色均为浅黄色或无色,细菌培养及细胞检查均无阳性;对照组术后随访情况:囊肿未复发患者55例,复发行二次手术患者3例.结论 对肾囊肿需手术治疗患者而言,PAES和经腹腔镜肾囊肿去顶术各有优劣势,具体实施方案需根据患者自身状况决定.对于单纯性肾囊肿并期望所花费用不高患者,对比于腹腔镜肾囊肿去顶术,PAES术具有并发症少、治疗承担费用低、患者遭受痛苦轻以及患者恢复较快等优势;而腹腔镜肾囊肿去顶术适用于其他类型肾囊肿患者,包括巨大肾囊肿、多发双肾囊肿或恶性无法排除等患者;若患者经PEAS疗效不佳甚至无效或者实施经皮肾穿刺不易者,均应考虑行腹腔镜肾囊肿去顶术.     

经皮囊内入路电切去顶术治疗单纯性肾囊肿16例报告

目的:评估经皮囊内入路电切去顶术治疗单纯性肾囊肿的疗效,以探讨低侵袭性、彻底的肾囊肿治疗方式。方法:我院于2011年4月~2013年12月采用经皮肾穿刺囊肿去顶术治疗单纯性肾囊肿患者16例。患者平均年龄59(23~78)岁;囊肿位于左肾13例,右肾3例。囊肿直径平均8.2(5.2~12.8)cm。术中在超声定位下应用经皮肾穿刺技术配合双极电切镜切除游离于肾脏外侧的囊壁,术后留置引流管2d。结果:14例患者手术顺利完成,囊肿完全消失。意外发现1例肾细胞癌,二期行肾部分切除术;1例因出血中转开放手术。平均手术时间68(15~125)min。平均随访15(1~32)个月,未见复发。结论:单纯性肾囊肿可以用经皮肾穿刺去顶术安全解决。此技术优于腹腔镜肾囊肿去顶减压术,避免了多个trocar的安置及广泛的肾周剥离,降低了手术难度。     

Simple renal cyst and hypertension: cause or coincidence?

Hypertension and simple renal cysts are frequent clinical diagnoses. With the widespread use of new non-invasive diagnostic technics such as abdominal ultrasound and computer-assisted tomography renal cysts are diagnosed with increasing frequency. In patients 50 years or older renal cysts of various size may be found in nearly one third. Similarly, the incidence of hypertension increases with age. Thus, the coexistence of a simple renal cyst and hypertension in a patient may represent a pure coincidence or be a cause of high blood pressure. The effect of cyst removal upon hypertension has been documented in 22 patients in the literature. Surgical cyst removal or percutaneous cyst aspiration caused a significant fall in blood pressure in most patients. The drop in blood pressure was closely related to an activation of the renin angiotensin system in the involved kidney. Fifteen patients (68%) were considered cured and 2 improved after the intervention. All patients had large cysts. It is suggested that in patients with large renal cysts the lesion may, through local tissue and/or renal arterial compression, cause ischemia and in turn activate the renin angiotensin system. Since most of the renal cysts are 2 cm or less in diameter this may represent a very rare event. In patients with large renal cysts and hypertension percutaneous needle aspiration of the cyst and/or renal venous renin determination may be useful tools to determine a causal rather than a coincidental relation between the 2 lesions.     

Cyst fluid from human autosomal dominant polycystic kidneys promotes cyst formation and expansion by renal epithelial cells in vitro.

Autosomal dominant polycystic kidney disease (ADPKD) is characterized by progressive renal enlargement, culminating in renal insufficiency in over one half of affected individuals. The highly variable onset and clinical course of ADPKD may be due to factors extrinsic to the genetically defined renal cysts. In this study, cyst fluid samples from 12 nonazotemic and 18 azotemic ADPKD subjects were examined for in vitro biologic activity that promotes cellular proliferation and the secretion of fluid by renal epithelial monolayers, two pathogenetic mechanisms that have critical roles in the formation and the rate of expansion of renal cysts. Cyst fluid added to culture medium (final concentrations, 1 to 20%) caused Madin-Darby canine kidney cells and human kidney cortex (HKC) cells derived from primary cultures to form cysts in Type I collagen matrix. Cyst fluid stimulated the net transepithelial secretion of fluid by polarized monolayers composed of these same cells. Absolute levels of fluid secretory activity determined by MDCK bioassay were correlated directly with the rate of fluid secretion by HKC cell monolayers and with the extent of cyst formation by MDCK and HKC cells embedded in collagen matrix. The secretory activity of urine was negligible; secretory activity was detectable in the serum of normal and ADPKD subjects, but the levels were much lower than in cyst fluid. cAMP agonists prostaglandins E1 and E2, arginine vasopressin, and 8-Br-cAMP stimulated fluid secretion by MDCK and HKC monolayers, but these substances did not cause HKC cells to form cysts in collagen matrix, whereas cyst fluid did. Among other naturally occurring growth factors and autacoids, only epidermal growth factor and transforming growth factor alpha stimulated cyst formation by HKC cells; however, the capacity of cyst fluid to stimulate fluid secretion was not affected by treatment with antiserum to epidermal growth factor. It was concluded that potent, and possibly unique, substances in the cyst fluids of individuals with ADPKD support and augment biologic processes in renal epithelial cells that may be important in the promotion of progressive cyst expansion.     

Efficacy of diffusion-weighted magnetic resonance imaging in detecting infected cysts in a case of polycystic kidney disease

Hepatic and/or renal cyst infection is a major complication in patients with polycystic kidney disease. In many cases, drainage of infected cysts is necessary, although accurate detection of infected cysts from among the numerous hepatic or renal cysts present is often difficult, because the findings of infected cysts on computed tomography and T1- and T2-weighted magnetic resonance imaging resemble those of normal cysts. We describe here a case of polycystic kidney disease complicated by hepatic cyst infection. On diffusion-weighted magnetic resonance imaging (DWMRI), which is occasionally used in the diagnosis of cerebral abscesses, infected hepatic cysts showed higher signal intensity than other cysts, facilitating differentiation of the cysts requiring drainage from numerous other cysts. Infected cysts showed a marked decrease of the apparent diffusion coefficient (ADC) values compared with those of normal cysts. DWMRI was very effective in detecting infected cysts in our patient and may be of value in other such cases with polycystic kidney disease.     

Abnormal function of renal tubules in patients with simple renal cysts

The present study aimed to asses the function of proximal and distal tubules in patients with simple renal cysts. Thirty-one patients with simple renal cysts and 10 healthy subjects were examined. Based on the cyst fluid/plasma sodium ratio, 25 cysts were found to be of proximal origin and 6 of undetermined origin. In all patients cyst fluid and plasma concentrations of β-2-microglobulin (β-2-MG), sodium, potassium, calcium, phosphorus and total protein were assessed. Urinary excretions of sodium, potassium, calcium, phosphorus, β-2-MG and Tamm-Horsfall protein (THP) were also estimated. Fractional excretion of β-2-MG was calculated. The concentrations of β-2-MG in fluid obtained from cysts of proximal origin were significantly higher than in fluid from cysts of undetermined origin (2.26±0.36 vs. 0.65±0.13 mg/l, p=0.0004). Concentrations of THP (6.85±1.21 vs. 3.14±1.06 μg/ml, p<0.05), and potassium (4.39±0.07 vs. 3.13±0.44 mmol/l, p<0.05) were also higher in fluid from proximal cysts than in fluid from cysts of undetermined origin. Plasma β-2-MG concentration was significantly higher in patients with proximal and undetermined cysts than in the control group (4.35±0.34 and 4.11±0.74 vs. 1.89±0.1 mg/l, p<0.001). Urinary β-2-MG excretion was also significantly higher in both groups of patients than in healthy subjects (474.8±165.9 and 346±94 vs. 100.2±19.6 μg/24 h, p<0.05). Urinary THP excretion was significantly higher in patients with proximal cysts than in healthy subjects (31.0±5.1 vs. 16.3±2.5 mg/24 h, p<0.05). From the results obtained in this study it seems that patients with simple renal cysts of proximal origin are characterized by abnormal tubular handling of β-2-MG, and calcium and THP excretion. Thus, in patients with proximal cysts presence of a latent renal tubulopathy seems to be likely.     

Percutaneous nephrostomic decortication: a microinvasive surgery for posterior renal cyst

To assess the safety, feasibility, and efficacy of a modified process we developed in order to perform decortication surgeries for simple renal cysts through a percutaneous approach, 18 patients with simple renal cysts larger than 5 cm were treated with our new technique, from November 2016 to January 2019. All of the cysts were evaluated with ultrasonography and contrast-enhanced computed tomography. The Surgical procedure: as the standard mini-Percutaneous Nephrostomy procedure, a puncture was made directly into the cyst through the cyst roof under ultrasound guidance. After the inner cyst wall examination, the sheath was then retracted to just outside the cyst roof. The sheath together with the scope was used to detach the roof from the perirenal fat, after which the cyst roof was resected using a laser. A drain tube was left in the retroperitoneal space for 1–2 days. Subsequently, all patients were discharged 1 to 2 days post-surgery. Skin incision was less than 1 cm. No major complication was observed. The follow-up time ranges from 14 to 37 months. One case had an incompletely resected cyst with the cyst volume being decreased by more than 60%. This patient didn’t receive any additional treatments during his follow-up. For all the other patients, the cysts had completely disappeared and no relapse had occurred. In conclusion, in the selected patients with a simple posterior renal cyst, our new technique is a safe and an effective option. It is also considered the least invasive decortication surgery for posterior renal cyst.     

Nonparasitic cysts of the liver. The case for conservative surgical management.

The recommended treatment for nonparasitic hepatic cysts (NPHC) has been either resection or drainage into a Roux loop of jejunum. From 1970-1984 a more conservative approach to NPHC was adopted in 22 patients with large symptomatic cysts. Seventeen patients were treated with simple unroofing without complication. By comparison, two of three patients treated by Roux-en-Y drainage developed infected hepatic cysts that required subsequent surgical drainage. Patients treated by external drainage without unroofing or hepatic resection had either cyst recurrence or complications. In conclusion, wide unroofing is the treatment of choice for NPHC even when the cyst fluid is bile stained.     

Simple renal cysts and circadian blood pressure: are they related to each other in patients with hypertension?

Previous studies have shown that the presence of simple renal cysts was related to hypertension. However, the relationship between simple renal cysts and circadian blood pressure was not studied before. Our study population comprised of newly diagnosed patients with essential hypertension. Medical history, physical examination and office blood pressure measurements, laboratory analysis, ambulatory blood pressure measurements, renal ultrasonography, and 24-h urine specimens were collected. In total, the study included 190 patients (male/female ratio 77/113; mean age 50.3 ± 11.3). Overall, 127 (66.8%) patients were dippers and 92 (48.4%) had at least one simple renal cyst. Thirty-five patients had solitary cysts and 57 patients had multiple cysts. Cysts were bilateral in 47 of patients. Most of ambulatory blood pressure recordings were higher in patients with at least one simple cyst when compared to patients without cysts. In multivariate logistic regression analysis, serum uric acid (P: 0.047, OR: 1.287, CI: 1.011–1.658), lower creatinine clearance (P: 0.001, OR: 1.030, CI: 1.012–1.049), presence of diabetes (P: 0.029, OR: 2.451, CI: 1.094–5.491), and presence of at least one cyst in each kidney (P: 0.002, OR: 3.087, CI: 1.533–6.212) were found to be independently related to nocturnal non-dipping. In conclusion, the presence of simple renal cysts is related to higher ambulatory BP and is associated with non-dipping phenomenon in patients with essential hypertension.     

Biochemical characteristics of cyst fluid in undialysed patients with autosomal dominant poiycystic kidney disease

Summary: The biochemical composition of cyst fluid was analysed in 148 cysts obtained from 10 patients with autosomal dominant polycystic kidney disease (ADPKD). Serum creatinine levels ranged from 1.7 to 9.0 mg/dL. No patients were receiving renal replacement therapy. Aspirated cyst volume ranged from 4-120 mL. There was no significant correlation between cyst volume and cyst sodium concentration ([Na]cyst). Cyst sodium concentration demonstrated a bimodal distribution pattern, with one peak from 10-20 mEq/L and the other from 140-150 mEq/L. the ratios of cyst fluid versus serum sodium concen tration ([Na]cyst/serum) were positively correlated with [C1]cyst/serum, while negatively correlated with [K]cyst/serum, [Ca]cyst/serum, [P]cyst/serum and [UA]cyst/serum. Based on the [Nalcyst/serum, the cysts were assigned to three types: proximal (0.8-1.4), indeterminant (0.4–0.8) and distal (<0.4). the percentage of each type was 54.7, 19.6 and 25.7%, respectively. There were no significant differences in [Na]cyst/serum between the right and left kidney in individual patients. the concentrations of amino acids were higher in the distal type than in the proximal type.
These results indicate the divergent function of the cyst-lining epithelia in polycystic kidneys.     

Conservative and radiological management of simple renal cysts: a comprehensive review

What's known on the subject? and What does the study add? Simple renal cysts are a common entity, which may need observation and follow‐up or treatment. The study, for the first time, systematically reviews the indications for follow‐up or radiological treatment of simple renal cysts. To review the conservative and radiological management of simple renal cysts a systematic literature review was performed. Simple renal cysts are commonly found in the adult population. Increasing age is highly associated with its incidence. When they remain asymptomatic they require neither treatment nor follow‐up. When the shape of the cyst is slightly irregular follow‐up is mandatory to exclude malignant progression. Symptomatic cysts require intervention. Ultrasound or computed tomography guidance have been effectively used for cyst puncture. However, simple fluid aspiration is ineffective leading to cyst recurrence. Aspiration should be accompanied with the injection of a sclerosing agent to destroy renal cyst epithelium. Several issues such as the ultimate technique and agent remain to be clarified. High rates of cyst disappearance and long‐lasting cyst volume reduction have been reported with the use of various sclerosants. Ethanol in high concentrations and multiple injections is more commonly used with new agents showing similar efficacy and better complication profile. Studies comparing radiological intervention to surgical excision are lacking. Simple renal cysts may not require treatment when asymptomatic. Radiological intervention with the use of sclerosants needs further evaluation and comparison with other treatment methods.     

Comparison of ethanol and sodium tetradecyl sulfate in the sclerotherapy of renal cyst

BACKGROUND AND PURPOSE: Renal cysts are common in the adult population. Symptomatic cysts traditionally have been treated by percutaneous aspiration with injection of sclerosant agents. Our aim was to compare the efficacy and side effects of ethanol and sodium tetradecyl sulfate (STDS) as sclerosants for symptomatic simple renal cyst. PATIENTS AND METHODS: Sixty-five patients with 68 symptomatic simple renal cysts were included in this study. An 8F pigtail catheter was inserted into the cyst under ultrasound guidance followed by aspiration of the cyst fluid. Either 95% ethanol (N = 34) or 3% STDS (N = 34), assigned randomly, was then instilled into the empty sac. Patients recorded any flank pain on a visual analog scale and were followed up by ultrasonography for 6 to 18 months. RESULTS: There was complete ablation of 28 (82%) and 26 (76%) cysts, partial regression of 3 (9%) and 6 (18%) cysts, and failure of treatment in 3 (9%) and 2 (6%) cysts in the ethanol and STDS groups, respectively. There was no major complication in either group. The pain caused by the injection was significantly less for the group receiving STDS (pain score 2.1 +/- 1.1 v 3.8 +/- 1.2 for ethanol; P = 0.019). CONCLUSIONS: Ethanol and STDS are simple, noninvasive, cost-effective, and well-tolerated sclerosants for the treatment of simple renal cysts. We prefer STDS as a first choice because it causes less pain.     

A study of the native kidneys in patients with chronic renal failure. Report 2: Correlation between cystic changes in native kidneys and development of renal tumor

The factors which made acquired cysts develop to renal tumors in chronic hemodialysis patients was investigated from clinical and histological findings. Although three renal tumors were found among 151 patients with chronic renal failure, clinically, one case had acquired cystic disease of the kidneys (ACDK), one case had simple cysts and the other case did not have any cyst. However, the last two cases had multiple small cysts histologically. In ACDK, renal tubules were degenerated and dilated, fused to each other, forming more larger cysts. Furthermore, epithelium of acquired cysts showed columer and dysplastic change, and papillary adenomas were developed into the inner space of the cyst wall. And ACDK kidney without renal tumor also revealed the same findings in histological examinations. It was postulated that renal tumor occurred from the papillary projections of the dysplastic epithelium of cysts. Therefore cysts in uremic patients seemed to be different from the simple cyst in normally functioning kidneys.     

Cystic transformation in native kidneys in renal allograft recipients with long-standing good function

Acquired renal cystic disease develops in the native kidneys of patients with renal allografts with long-standing poor function. However, there has been no long-term prospective study of the regression or development of cysts in native kidneys of renal allograft recipients with good long-term function (serum creatinine: 114 +/- 24 mumol/l). We followed 61 renal allograft recipients for 63.5 +/- 29.0 months (mean +/- SD) using computed tomography (CT scan) every 1 or 2 years after transplantation. The cyst grade at pretransplantation was significantly reduced at the first study after transplantation (0.98 +/- 1.39 vs. 0.57 +/- 0.96; p less than 0.01). Baseline study after transplantation revealed that the incidence of cysts in native kidneys was 22/61 (36.1%) and 26/61 (42.6%) in the follow-up study. In 32 patients (52.5%), there were no visible cysts in the native kidneys. In 9 patients (14.8%), there was no change in the number of cysts during follow-up, while in another 9 patients the number of cysts decreased. On the other hand, the number of cysts increased in 11 patients (18.0%) during follow-up. The mean follow-up duration was longer in the group with an increased number of cysts than in the groups with no visible cysts or a decrease in number. Biochemical analysis of cyst fluid from newly developed cysts in 2 patients showed differences from the pattern in acquired renal cystic disease of hemodialysis patients. These results indicate that after regression of acquired cysts in most allograft recipients, no or only a few cysts persist in patients with good graft function. The remaining cysts continue to regress further in some patients.(ABSTRACT TRUNCATED AT 250 WORDS)     

改进后的肾囊肿CT引导下硬化剂治疗术

目的观察改进肾囊肿CT引导下硬化剂治疗术的疗效。方法386例肾囊肿经皮穿刺抽吸乙醇治疗,其中,单纯性肾囊肿243例,多发囊肿113例,双肾均有囊肿30例。囊肿直径1.5~7 cm。用9-14 G穿刺针穿刺抽吸,抽出囊液5~700 ml,注入99.7%无水乙醇保留而不抽出,乙醇量以抽出量的25%~50%计算。结果随访193例(251个囊肿),时间3个月~12个月,囊肿治疗有效率达98%以上,囊腔消失率达87%,并发症仅为局部腰部胀痛,无严重后遗症。结论改进后的CT引导下肾囊肿硬化剂治疗术是一种安全、并发症少,操作简单的有效治疗方法。