RESUMO
BACKGROUND-OBJECTIVE: Prior studies have suggested a higher prevalence of simple renal cysts (SRC) among patients with aortic disease, including abdominal aortic aneurysms (AAA). Thus, the aim of this study was to systematically review all currently available literature and investigate whether patients with AAA are more likely to have SRC. METHODS: This study was performed according to the PRISMA guidelines. A meta-analysis was conducted with the use of random effects modeling and the I-square was used to assess heterogeneity. Odds ratios (OR) and the corresponding 95% confidence intervals (CI) were synthesized to compare the prevalence of several patients' characteristics between AAA vs. no-AAA cases. RESULTS: Eleven retrospective studies, 9 comparative (AAA vs. no-AAA groups) and 3 single-arm (AAA group), were included in this meta-analysis, enrolling patients (AAA: Nâ¯=â¯2,297 vs. no-AAA: Nâ¯=â¯35,873) who underwent computed tomography angiography as part of screening or preoperative evaluation for reasons other than AAA. The cumulative incidence of SRC among patients with AAA and no-AAA was 55% (95% CI: 49%-61%) and 32% (95% CI: 22%-42%) respectively, with a statistically higher odds of SRC among patients with AAA (OR: 3.02; 95% CI: 2.01-4.56; P< 0.001). The difference in SRC prevalence remained statistically significant in a sensitivity analysis, after excluding the study with the largest sample size (OR: 2.71; 95% CI: 1.91-3.84; P< 0.001). CONCLUSIONS: Our meta-analysis demonstrated a 3-fold increased prevalence of SRC in patients with AAA compared to no-AAA cases, indicating that the pathogenic processes underlying SRC and AAA could share a common pathophysiologic mechanism. Thus, patients with SRC could be considered at high risk for AAA formation, potentially warranting an earlier AAA screening.
Assuntos
Aneurisma da Aorta Abdominal/complicações , Doenças Renais Císticas/complicações , Comorbidade , Intervalos de Confiança , Dislipidemias/complicações , Feminino , Humanos , Doenças Renais Císticas/epidemiologia , Masculino , Razão de Chances , PrevalênciaRESUMO
The aim of this study was to determine the prevalence of simple renal cysts in gout patients and evaluate associated risk factors for its development. Hundred and forty-six patients followed at our outpatient Gout Unit and 47 sex- and age-matched healthy kidney donors who had undergone routine renal ultrasonography, using a static gray scale and real-time B-mode units with a 3.5- or 5.0-MHz transducer, were evaluated for the presence of renal cysts. Demographic and clinical characteristics of gout patients were evaluated considering possible risk factors for the occurrence of simple renal cysts such as age, male gender, hypertension, and renal impairment. The prevalence of simple renal cyst was 26.0 % in gout patients and 10.6 % in control group (P = 0.045). Gout patients with simple renal cysts presented less renal lithiasis than those without this complication (5.2 vs 25.9 %; P = 0.003) in spite of an overall higher frequency of renal stones in gout patients compared to control group (20.5 vs. 6.3 %, P = 0.025). The presence of simple renal cyst in gout was not associated with previously reported factors such as age (P = 0.296), male predominance (P = 0.688), hypertension (P = 0.314), and renal impairment (P = 254). Moreover, no association with disease duration (P = 0.843) or tophi (P = 0.616) was observed. In conclusion, gout patients have an increased prevalence of simple renal cysts associated with a lower occurrence of nephrolithiasis. Whether renal cysts have any protective effect in the development of nephrolithiasis in gout remains to be determined.
Assuntos
Gota/complicações , Doenças Renais Císticas/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nefrolitíase/epidemiologia , PrevalênciaRESUMO
OBJECTIVES: To report our experience with renal cell carcinoma in patients with end-stage renal failure receiving dialysis at two institutions that perform a large number of transplantations. Renal cell carcinoma is more frequent in patients with end-stage renal failure treated with dialysis and in renal transplant patients than in the population at large. METHODS: We reviewed the case histories of 1375 consecutive patients who had transplanted kidneys functioning for more than 1 year. RESULTS: Eleven renal tumors were found in 10 patients (1.37%); 10 of the tumors (90%) were in the native kidney (9 unilateral and 1 bilateral) and 1 (10%) was in the transplanted kidney. The tumors in the native kidneys were discovered incidentally. Three were in organs removed for treatment of arterial hypertension and the other seven were found by ultrasonography. The tumor in the transplanted kidney was found after nephrectomy for the treatment of hematuria. The tumor types were clear cell in six, papillary in four, and chromophobe in one. Of the 9 patients who were treated with radical nephrectomy, 7 were alive with no evidence of the disease and 2 had died of other causes, also with no evidence of the disease. One patient who already had metastases at the diagnosis did not undergo surgery and died 4 months later. CONCLUSIONS: The native kidneys of renal transplant patients should be examined by ultrasonography annually because they are at greater risk of renal cell carcinoma. Radical nephrectomy cures those cases in which the tumors are clinically localized and 6 cm or less in size.
Assuntos
Carcinoma de Células Renais/epidemiologia , Neoplasias Renais/epidemiologia , Transplante de Rim , Adenocarcinoma de Células Claras/epidemiologia , Adenocarcinoma Papilar/epidemiologia , Adulto , Idoso , Comorbidade , Feminino , Humanos , Doenças Renais Císticas/epidemiologia , Falência Renal Crônica/cirurgia , Transplante de Rim/imunologia , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
El propósito del estudio fue explorar por medio de ultrasonido ambos riñones para determinar la frecuencia de quistes renales, independientemente de su etiología. Este fue un estudio prospectivo y observacional practicado en 1064 pacientes, 105 varones y 959 mujeres, que acudieron al departamento de radiodiagnóstico por diversos motivos. Se identificaron quistes renales en 24 pacientes (2.2 por ciento); de ellos, siete (0.6 por ciento) eran del sexo masculino y 17 (1.6 por ciento) del femenino. Del total de los pacientes con quistes, 17 se encontraban por encima del quinto decenio de la vida (70.8 por ciento). Se concluye que los quistes renales tienen una frecuencia elevada en pacientes que se encuentran por encima del quinto decenio de la vida. La mayoría tienen un curso asintomático y constituyen un hallazgo de exploración. Los pacientes sintomáticos fueron los que tenían quistes múltiples unilaterales o bilaterales