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Clinical Correlates of Mass Effect in Autosomal Dominant Polycystic Kidney Disease.
- Source :
-
PloS one [PLoS One] 2015 Dec 07; Vol. 10 (12), pp. e0144526. Date of Electronic Publication: 2015 Dec 07 (Print Publication: 2015). - Publication Year :
- 2015
-
Abstract
- Mass effect from polycystic kidney and liver enlargement can result in significant clinical complications and symptoms in autosomal dominant polycystic kidney disease (ADPKD). In this single-center study, we examined the correlation of height-adjusted total liver volume (htTLV) and total kidney volume (htTKV) by CT imaging with hepatic complications (n = 461) and abdominal symptoms (n = 253) in patients with ADPKD. "Mass-effect" complications were assessed by review of medical records and abdominal symptoms, by a standardized research questionnaire. Overall, 91.8% of patients had 4 or more liver cysts on CT scans. Polycystic liver disease (PLD) was classified as none or mild (htTLV < 1,600 mL/m); moderate (1,600 ≤ htTLV <3,200 mL/m); and severe (htTLV ≥ 3,200 mL/m). The prevalence of moderate and severe PLD in our patient cohort was 11.7% (n = 54/461) and 4.8% (n = 22/461), respectively, with a female predominance in both the moderate (61.1%) and severe (95.5%) PLD groups. Pressure-related complications such as leg edema (20.4%), ascites (16.6%), and hernia (3.6%) were common, and patients with moderate to severe PLD exhibited a 6-fold increased risk (compared to no or mild PLD) for these complications in multivariate analysis. Similarly, abdominal symptoms including back pain (58.8%), flank pain (53.1%), abdominal fullness (46.5%), and dyspnea/chest-discomfort (44.3%) were very common, and patients with moderate to severe PLD exhibited a 5-fold increased risk for these symptoms. Moderate to severe PLD is a common and clinically important problem in ~16% of patients with ADPKD who may benefit from referral to specialized centers for further management.
- Subjects :
- Cysts epidemiology
Female
Follow-Up Studies
Humans
Liver Diseases epidemiology
Male
Middle Aged
Organ Size
Polycystic Kidney, Autosomal Dominant epidemiology
Prevalence
Prognosis
Republic of Korea epidemiology
Retrospective Studies
Cysts complications
Cysts pathology
Liver Diseases complications
Liver Diseases pathology
Polycystic Kidney, Autosomal Dominant etiology
Polycystic Kidney, Autosomal Dominant pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 10
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 26641645
- Full Text :
- https://doi.org/10.1371/journal.pone.0144526