Simple Renal Cysts Associated with Increased Risk of Renal Dysfunction

目的：本研究的目是探究某台灣族群單純腎囊腫及其特徵與腎功能不良的相關性。方法：研究對象為2001年1月至2007年10月至成大醫院接受健康檢查之7,339位受檢者。估算腎絲球過濾率由簡化MDRD公式計算得出，而蛋白尿由尿液試紙分析決定有無。單純腎囊腫經由超音波檢查診斷得知。針對腎囊腫的特徵，包括數量、分布及大小有更進一步分析。最後運用共變數分析及多變項邏輯回歸分析分別估算腎絲球過濾率和蛋白尿的風險。結果：整體有693位（9.4%）研究對象有單純腎囊腫。有單純腎囊腫者比起無腎囊腫者有較低的估算腎絲球過濾率。關於腎囊腫的特徵，有多顆、兩側或2公分以上腎囊腫者，比起無腎囊腫者有顯著較低的估算腎絲球過濾率。僅多顆或兩側腎囊腫者有顯著較高的蛋白尿風險。結論：具有多顆、兩側及大尺寸（2公分以上）的單純腎囊腫者有較低的估算腎絲球過濾率；而蛋白尿的風險則僅見於有多顆或兩側側腎囊腫者。因此，對於有單純腎囊腫個案也應該評估相關腎功能不良的可能。

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並列摘要

Purpose: The aim of this study was to investigate the association of simple renal cysts (SRC) and their characteristics with renal dysfunction in a Taiwanese population. Methods: We enrolled 7,339 eligible subjects undergoing a health checkup in National Cheng Kung University Hospital between January 2001 and October 2007. Estimated glomerular filtration rate (eGFR) was calculated by the abbreviated Modification of Diet in Renal Diseases (MDRD) equation and proteinuria was determined by dipstick urinalysis. SRC were identified on the basis of standard sonographic parameters. Renal cyst characteristics, including cyst number, distribution, and size, were further investigated. Analysis of covariance and multivariate logistic regression were performed for analyses of eGFR and proteinuria, respectively. Results: Overall, 693 subjects (9.4%) had at least one SRC. Subjects with SRC had lower eGFR compared to those without SRC. Multiple cysts, not solitary ones, were associated with lower eGFR when compared to no cysts. Compared to subjects with bilateral cysts, those with unilateral cyst(s) or no cysts had higher eGFR. Subjects with cyst size ≥2 cm, but not ＜2cm, had lower eGFR compared to those without SRC. Subjects with multiple cysts, not solitary ones, had a higher risk of proteinuria than those without; while bilateral cysts, and not unilateral ones, increased the risk of proteinuria. Conclusion: SRC with multiple, bilateral and large-sized ( ≥2 cm) characteristics were associated with deceased eGFR; while the risk of proteinuria increased only in multiple or bilateral cysts. Subjects with SRC should also be assessed for the possibility of renal dysfunction.