Intimal thickening of renal arterioles in a case of thrombotic thrombocytopenic purpura: clinical course and autopsy findings.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to H Kitada.
Explore the source record for details and available documents.
Four surgical cases of acquired cystic disease of the kidney in the third decade are reported, which include renal cell carcinoma in three patients and multiple adenomas and cystadenomas in all patients. The intervening parenchyma of these kidneys was disorganized as end stage kidney and numerous cysts were found in both kidneys. Some of the cysts were lined by hyperplastic epithelium consisting of clear and granular cells arranged in piled up and papillary fashion. These cysts were diagnosed as cystadenoma. Multiple solid adenomas of a 28-year-old male on hemodialysis for 6 years were of various size as if arranged in developing stage of the growth. Summing up all cases included in the literature, the mean duration of hemodialysis of the cases with renal tumor was 5.2 years, while 2.9 years without tumor. With increase of duration of hemodialysis, acquired cystic disease of the kidney is exposed to a high risk of developing malignancy.
The fate of the contracted kidney in long-term hemodialysis patients was examined. Total kidney volume was measured by computer assisted tomography in 96 chronically hemodialyzed patients with chronic renal failure due to chronic glomerulonephritis. The presence of cysts and/or tumor in the renal parenchyma was evaluated. Kidney volume decreased progressively up to 3 years after the start of dialysis. However, after 4 years of dialysis, it then increased in a number of cases. Multiple cysts were found in 43.5% of patients on dialysis for less than 3 years and in 79.3% of patients who had been on dialysis for more than 3 years. They were found in 100% of those whose total kidney volume exceeded 50 ml despite more than 3 years dialysis. Bilateral nephrectomy was performed in 4 cases who had been dialyzed for more than 5 years and all showed acquired cystic disease of the kidney. Three out of 4 resected cases had adenocarcinoma and multiple adenomas in addition to acquired cystic disease of the kidneys. The other had intracystic epithelial hyperplasia. These results suggest that long-term hemodialysis is associated with a very high incidence of acquired cystic disease of the kidney. There is frequent enlargement of the contracted kidney, and a high incidence of renal adenocarcinoma in patients with glomerulonephritis leading to treatment with hemodialysis.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
An analysis of dynamic CT curves in 12 patients with acute renal failure was performed. An oliguric patient who demonstrates corticomedullary differentiation on CT images will develop diuresis within 4 days. A corticoaortic junction time of more than 180 s associated with no differentiation between cortex and medulla is associated with prolonged oligoanuria. Impending diuresis is heralded by a corticoaortic junction time of less than 180 s. These preliminary results suggest that an analysis of dynamic CT curves in acute renal failure can predict the time of appearance of the diuretic stage.
The effect of renal transplantation on acquired cystic disease of the kidney in patients who have been on hemodialysis for more than 5 years was examined in 7 cases by computer-assisted tomography (CT scan). Almost all acquired cysts disappeared, and the size of the original kidneys decreased remarkably in 2 cases 8--10 months after transplantation. 3 other patients, in whom CT scans were performed only after transplantation, showed contracted scarred kidneys with few or no cysts. The involution of acquired cysts was incomplete in 1 case, in whom the cysts persisted for 3 years and 2 months, despite normal renal function. The last case, who was off hemodialysis only for 4 months, exhibited enlargement of the original kidneys and an increase in the number of cysts. These results suggest that a significant number of acquired renal cysts in dialyzed patients with end-stage kidney disease regress rapidly after successful renal transplantation, but this is not always so.