The clinical significances of simple renal cyst: Is it related to hypertension or renal dysfunction?

Chin, Ho Jun; Ro, Han; Lee, H.J.; Na, K.Y.; Chae, Dong‐Wan

doi:10.1038/sj.ki.5001784

Cited by 80 publications

(117 citation statements)

References 22 publications

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“…Local ischemia caused by cyst expansion leads to the activation of the renin-angiotensin system. As a result, hypertension affects 50-75% of adults with autosomal dominant polycystic kidney disease and up to 80% of those with end-stage renal failure [17,18] . In our analysis, the number of patients who had hypertension was very high, at 56.3%.…”

Section: Resultsmentioning

confidence: 99%

The Growth of Renal Cysts According to the Exophytic Index of the RENAL Nephrometry Scoring System

Park

Kang

2016

Journal of Nephrology Research

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higher than mild and moderate exophytic renal cyst. INTRODUCTIONRenal cysts are acquired lesions that most commonly affect the elderly population [1] . Autopsy studies have reported a 50% incidence of renal cysts after the age of 50 years [2] . The prevalence of renal cysts is approximately 10%, ranging from 4% in the third decade to 19% in the sixth decade [3] . There is an increase in the size and number of cysts over time in cyst-bearing individuals. Previous longterm follow-up data have shown that, simple renal cysts continue to increase in size with age > 10 years, and sometimes increase rapidly, particularly in younger patients [4] . However, this study also showed decreased growth rate of cysts with increased age. Renal cysts originate from weakened of the tubular basement membrane of the distal convoluted or collecting duct cells [2] . As results, a diverticulum is formed, which can subsequently develop into a simple renal cyst [5,6] . The reported risk factors for renal cysts include old age, male gender, renal dysfunction, and hypertension [7] . However, given the retrospective nature of these studies, the associations could be coincidental. The only persistent confounder among all reported associations was increasing age [4,7,8] . Therefore, we analyzed the discrepancy of an increasing rate of simple renal cysts according to initial size, location, and exophytic index stratified using the RENAL nephrometry scoring system in this study. MATERIALS AND METHODS Study populationThis study was conducted after receiving approval from our ABSTRACT AIM: To investigate the growth patterns of renal cysts according to location, exophytic degree and Bosniak classification. METHODS: From December 2000 to September 2012, a total of 252 patients (340 renal cysts) were included in this study. All patients had undergone computed tomography (CT) scans of the kidney level at least twice, and six months apart for any reason. Renal cyst data were assessed according to cyst side (right or left), location (upper, mid or lower), characteristics (Bosniak classification), and exophytic degree (1,2, and 3) which were stratified using the RENAL nephrometry score. The growth rate of renal cyst was analyzed according to each parameter using linear correlation analysis. RESULTS:The mean size of renal cyst increased from 3.81 cm to 3.85 cm during a mean follow-up of 20.1 months, not significantly (p = 0.121). Among 340 renal cyst units, 180 renal cysts had an exophytic degree index of 1 (52.9%), 90 had an index 2 (26.5%), and 70 had an index of 3 (20.6%). After a mean of 20.1 months of follow-up, only exophytic degree 3 renal cysts increased in size significantly from 4.54 to 5.76 cm (p = 0.018). The annual growth rate in exophytic degree 3 renal cysts was 2.4 mm (r 2 = 0.263), which was higher than that for renal cysts at other site locations. CONCLUSION: The growth rate of renal cysts varied according to exophytic location. The growth rate of exophytic renal cysts was

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Section: Resultsmentioning

confidence: 99%

The Growth of Renal Cysts According to the Exophytic Index of the RENAL Nephrometry Scoring System

Park

Kang

2016

Journal of Nephrology Research

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“…[37][38][39] Previous studies in healthy subjects described associations between hypertension and benign renal cysts. [40][41][42] In a cross-sectional analysis of hospitalized patients without overt renal disease undergoing an abdominal computed tomography scan, the presence of cysts was associated with a reduced renal function estimated by creatinine clearance. 33 In our cohort, the association between copeptin and cysts was independent of age, hypertension, kidney function, and even urinary concentration, suggesting a distinct pathway.…”

Section: Discussionmentioning

confidence: 99%

Copeptin Is Associated with Kidney Length, Renal Function, and Prevalence of Simple Cysts in a Population-Based Study

Ponte

Pruijm

Ackermann

et al. 2015

Journal of the American Society of Nephrology

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Arginine vasopressin (AVP) has a key role in osmoregulation by facilitating water transport in the collecting duct. Recent evidence suggests that AVP may have additional effects on renal function and favor cyst growth in polycystic kidney disease. Whether AVP also affects kidney structure in the general population is unknown. We analyzed the association of copeptin, an established surrogate for AVP, with parameters of renal function and morphology in a multicentric population-based cohort. Participants from families of European ancestry were randomly selected in three Swiss cities. We used linear multilevel regression analysis to explore the association of copeptin with renal function parameters as well as kidney length and the presence of simple renal cysts assessed by ultrasound examination. Copeptin levels were log-transformed. The 529 women and 481 men had median copeptin levels of 3.0 and 5.2 pmol/L, respectively (P,0.001). In multivariable analyses, the copeptin level was associated inversely with eGFR (b=22.1; 95% confidence interval [95% CI], 23.3 to 20.8; P=0.002) and kidney length (b=21.2; 95% CI, 21.9 to 20.4; P=0.003) but positively with 24-hour urinary albumin excretion (b=0.11; 95% CI, 0.01 to 0.20; P=0.03) and urine osmolality (b=0.08; 95% CI, 0.05 to 0.10; P,0.001). A positive association was found between the copeptin level and the presence of renal cysts (odds ratio, 1.6; 95% CI, 1.1 to 2.4; P=0.02). These results suggest that AVP has a pleiotropic role in renal function and may favor the development of simple renal cysts. The antidiuretic hormone arginine vasopressin (AVP) plays an essential role in osmoregulation by facilitating water transport in the collecting duct. 1 This effect is mediated by the stimulation of the G protein-coupled vasopressin V2 receptor (V2R), increasing cAMP levels and leading to a transient increase in osmotic water transport across the principal cells. 2 Furthermore, it was recently demonstrated that V2Rs are also expressed in the thick ascending limb of the human kidney. 3,4 In addition to the V2R, AVP acts on the V1a receptor (Ca 2+ as second messenger), which is distributed in the endothelial cells lining systemic and renal blood vessels and capillaries (including vasa recta), as well as the glomerulus, the macula densa, the medullary interstitial cells, and the cortical collecting duct. [5][6][7] Of note, V1a receptors seem to

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“…Fatores confundidores como a idade, género, taxa de filtração glomerular (TFG) e proteinúria devem ser examinados. 12 Alguns autores afirmam que os quistos renais são a causa da HTA. Referem que a expansão dos quistos e a compressão arterial ativam o SRAA provocando isquemia renal.…”

Section: Comentáriounclassified

“…12 Outra explicação sugere que a perda de nefrónios associada à idade, está envolvida tanto no desenvolvimento de HTA, como na formação de quistos renais.…”

Section: Comentáriounclassified

Hipertensão Arterial Sistémica Secundária: Incertezas do Diagnóstico

et al. 2017

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RESUMOA hipertensão arterial sistémica configura-se hoje como um problema de saúde pública mundial, sendo a taxa de prevalência em Portugal de 26,9%. De acordo com a sua etiologia classifica-se em hipertensão arterial sistémica primária ou secundária. Em cerca de 90% dos casos, não é possível estabelecer uma causa e por isso a hipertensão arterial sistémica denomina-se primária. Nos restantes 5% a 10%, pode ser identificada uma causa secundária, potencialmente tratável. Para que o estudo da hipertensão arterial sistémica secundária seja custo-eficaz, torna-se essencial perceber quais os doentes a investigar, com que meios, e qual a melhor estratégia a adotar. As principais causas apontadas como responsáveis pela hipertensão arterial sistémica secundária são: patologia renal; endócrina; vascular e síndrome da apneia obstrutiva do sono. Entre estas, algumas são consensuais e outras mais controversas na literatura. A este propósito apresentamos dois casos de hipertensão arterial sistémica, cuja etiologia potencialmente secundária ainda é foco de debate. Palavras-chave: Artéria Renal/anomalias congénitas; Doenças Renais Quísticas; Hipertensão/diagnóstico; Pressão Sanguínea ABSTRACTArterial hypertension is regarded today as a global public health problem, and the prevalence rate in Portugal is 26.9%. According to the etiology, is classified into primary or secondary arterial hypertension. In about 90% of cases it is not possible to establish a cause, so is called primary arterial hypertension. In the remaining 5 to 10%, it can be identified secondary causes, which are potentially treatable. For secondary arterial hypertension study to be cost-effective, it is essential to understand which patients investigate, and evaluate the best strategy to adopt. The main causes identified as responsible for secondary arterial hypertension are: kidney disease; endocrine and vascular diseases and obstructive sleep apnea. Among these some are consensual, and others more controversial in the literature. In this regard we present two cases of arterial hypertension, which are potentially secondary in etiology, but still focus of debate. Keywords: Blood Pressure; Hypertension/diagnosis; Kidney Diseases, Cystic; Renal Artery/abnormalitie INTRODUÇÃO A hipertensão arterial (HTA) é um fator de risco major para doença cardiovascular.1,2 A HTA secundária define-se como um aumento da pressão arterial devido a uma causa identificável, 3 ocorrendo em 5% -10% de todos os casos de HTA.4 Devido a esta baixa percentagem, é primordial saber que doentes devemos estudar. A história clínica e o exame objetivo são instrumentos valiosos para guiar o clínico nesta seleção.A HTA secundária está associada a uma patologia potencialmente tratável, requerendo alto grau de suspeita. Na pesquisa inicial devemos excluir a HTA de bata branca, aferir a adesão terapêutica e identificar sinais e sintomas indicadores de HTA secundária. Devemos estudar jovens sem outros fatores de risco cardiovasculares (FRCV); HTA de início recente ou previamente controlada; HTA com l...

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The clinical significances of simple renal cyst: Is it related to hypertension or renal dysfunction?

Cited by 80 publications

References 22 publications

The Growth of Renal Cysts According to the Exophytic Index of the RENAL Nephrometry Scoring System

The Growth of Renal Cysts According to the Exophytic Index of the RENAL Nephrometry Scoring System

Copeptin Is Associated with Kidney Length, Renal Function, and Prevalence of Simple Cysts in a Population-Based Study

Hipertensão Arterial Sistémica Secundária: Incertezas do Diagnóstico

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