Relationship Between Sporadic Renal Cysts and Renal Function Detected by Isotope Renography in Type 2 Diabetes

Abstract

Purpose This study aimed to reveal the relationship between the volume of sporadic renal cysts and renal function in patients with type 2 diabetes (T2D). Materials and Methods One hundred and seventy-one patients that underwent renal imaging and other routine examinations at the Shanghai Pudong Hospital were included in this study. The Gates’ method of glomerular filtration rate (GFR) was measured by 99m Tc-DTPA renal dynamic imaging in addition to the eGFR, calculated by the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). Results Our results showed that BMI, total iGFR, and eGFR showed significant differences between patients with T2D with or without SRC (p < 0.05). Spearman correlation analysis showed that cyst volume was positively correlated with Scr and gender but not iGFR (p > 0.05). The total iGFR positively correlated with eGFR (r = 0.83, p < 0.0001) and negatively with Scr (r = −0.78, p < 0.0001), age (r = −0.43, p < 0.0001), duration of T2D (r = −0.25, p = 0.001), and BMI (r = −0.21, p = 0.006) but not gender (r = −0.03, p = 0.668). The multilinear regression model revealed that gender (β = 0.346, p < 0.001), iGFR (β = −0.705, p < 0.001), and serum uric acid (β = 0.195, p = 0.032) were independent predictors of Scr. Moreover, we observed a significant increase in Scr in males (p < 0.05). Finally, we found that the split kidney function reflected by iGFR and related parameters such as time to peak (PTT) and half time of excretion (excrete t1/2) did not mutually distinguish from each other significantly whether they are measured in patients with renal cysts or in those without renal cysts (p > 0.05). Conclusion Our preliminary results suggest that in T2D, SRCs may be a renal complication of diabetic nephropathy. Although we found that the patients with renal cysts may display reduced iGFR, the volume of simple cysts seems not to exacerbate renal insufficiency. Isotope renography is a useful tool to evaluate the split kidney functions in diabetic patients who acquire single-side cysts.

Decline in measured glomerular filtration rate is associated with simple renal cyst in Chinese patients with type 2 diabetes

“…In recent studies, Kwon et al ., 10 carried out dimercaptosuccinic acid renal scans to calculate split renal function, and found that the relative renal function of the cystic kidney units was significantly lower. Li et al ., 11 measured GFR by 99mTc‐DTPA renal dynamic imaging, and found that SRC was associated with reduced mGFR in patients with type 2 diabetes mellitus. However, these studies had a small sample size of 50–171 cases.…”