Clinical Correlates of Mass Effect in Autosomal Dominant Polycystic Kidney Disease
- Authors
- Kim, Hyunsuk; Park, Hayne Cho; Ryu, Hyunjin; Kim, Kiwon; Kim, Hyo Sang; Oh, Kook-Hwan; Yu, Su Jong; Chung, Jin Wook; Cho, Jeong Yeon; Kim, Seung Hyup; Cheong, Hae Il; Lee, Kyubeck; Park, Jong Hoon; Pei, York; Hwang, Young-Hwan; Ahn, Curie
- Issue Date
- Dec-2015
- Publisher
- PUBLIC LIBRARY SCIENCE
- Citation
- PLOS ONE, v.10, no.12
- Journal Title
- PLOS ONE
- Volume
- 10
- Number
- 12
- URI
- https://scholarworks.sookmyung.ac.kr/handle/2020.sw.sookmyung/10171
- DOI
- 10.1371/journal.pone.0144526
- ISSN
- 1932-6203
- 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 similar to 16% of patients with ADPKD who may benefit from referral to specialized centers for further management.
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