NDLI: Evidence of extraordinary growth in the progressive enlargement of renal cysts.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Grantham, Jared J. Cook, Larry T. Wetzel, Louis H. Cadnapaphornchai, Melissa A. Bae, Kyongtae T.
Description	Country affiliation: United States Author Affiliation: Grantham JJ ( Kidney Institute, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA. jgrantha@kumc.edu)
Abstract	BACKGROUND AND OBJECTIVES: In autosomal dominant polycystic kidney disease, cysts derived from tubules are detected at birth by ultrasound (threshold for detection >7.0 mm); thus, fetal cyst growth rates must exceed 2300%/yr. In adults, the combined renal cyst component enlarges at approximately 12%/yr by growth of individual cysts. To explore this discrepancy, the growth rates of individual cysts were determined in adult polycystic kidneys. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Diameter, volume, and growth rates of individual cysts were measured by magnetic resonance in 30 individual cysts in three adult patients over a span of 3 years. Results were confirmed in 22 cysts measured in five patients by computed tomography over a span of 11 years. RESULTS: Mean cyst diameters were 20.4 +/- 9.9 mm (range 7.1 to 40.5 mm) at baseline and 25.8 +/- 15.6 mm (range 7.8 to 49.6 mm) after 3 years. Mean cyst volumes, determined by manual segmentation and summation of magnetic resonance cross sections, were 8.7 +/- 12.9 cm(3) (0.3 to 43.3 cm(3)) and 24.2 +/- 66.3 cm(3) (0.3 to 364.8 cm(3)) after 3 years. Mean cyst growth rates ranged from 6.9 to 23.9%/yr; the maximum growth rate was 71.1%/yr, far less than required to develop a 7-mm diameter cyst in utero. Results were similar in 22 cysts examined by computed tomography. CONCLUSIONS: It was concluded that renal cysts detected by ultrasound in newborns must have grown at exuberant rates in utero; thereafter, expansion appears to proceed at much slower rates.
File Format	HTM / HTML
ISSN	15559041
e-ISSN	1555905X
DOI	10.2215/CJN.00550110
Journal	Clinical Journal of the American Society of Nephrology
Issue Number	5
Volume Number	5
Language	English
Publisher	American Society of Nephrology
Publisher Date	2010-05-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't Polycystic Kidney Diseases Tomography, X-ray Computed Discipline Nephrology Kidney Disease Progression Pathology Magnetic Resonance Imaging Adolescent Ultrasonography Infant, Newborn
Content Type	Text
Resource Type	Article
Subject	Transplantation Critical Care and Intensive Care Medicine Nephrology Epidemiology

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