臨牀透析 Vol.18 No.5(2-4)


特集名 透析と嚢胞性腎疾患
題名 腎不全と関連する他の嚢胞性腎疾患 (4) 髄質嚢胞性疾患
発刊年月 2002年 05月
著者 力石 辰也 聖マリアンナ医科大学泌尿器科
【 要旨 】 髄質嚢胞腎は両側性に髄質由来の多発性嚢胞に間質の線維化を伴う疾患で,発症年齢と遺伝形式を除くと臨床的・病理学的に若年性ネフロン癆と同一の疾患と考えられ,juvenile nephronophthisis-medullary cystic disease (JN-MCD) complexという概念も提唱されている.常染色体優性の遺伝形式をとり,成人に発症し,進行性の腎機能障害から慢性腎不全に至る疾患である.皮髄境界に直径1~20mmの多発性の嚢胞が認められる.原因治療はなく,ナトリウムの補充とエリスロポエチン投与を行う.保存的治療の後に末期腎不全に至った後は,血液透析・腹膜灌流・腎移植の対象となる.
Theme Dialysis and Cystic Renal Disease
Title Medullary cystic disease of the kidney
Author Tatsuya Chikaraishi Department of Urology, St. Marianna University School of Medicine
[ Summary ] Medullary cystic disease involves multiple cystic lesions associated with variable enlargement of the distal tubules and collecting ducts, along with interstitial fibrosis. Except for hereditary features and ages of presentation, medullary cystic disease and juvenile nephronophthisis are essentially identical, clinically and pathologically. Some authors wish to combine the two disorders under the name "juvenile nephronophthisis-medullary cystic disease complex". Medullary cystic disease is an autosomal dominant disorder that usually becomes present in adults, with progressively deteriorating renal function into the end stage. Medullary cysts, which range in diameter from 1mm to 10mm, usually appear at the corticomedullary junction. Only conservative treatments, including Na+ replacement, or erythropoietin, are available. When endstage renal disease is established after conservative treatment, hemodialysis, peritoneal dialysis, or kidney transplantation is indicated.
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