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Kidney Week

Abstract: SA-PO937

Higher Number of Kidney Cysts Predicts Progressive CKD After Radical Nephrectomy Independent of Kidney Function

Session Information

Category: CKD (Non-Dialysis)

  • 2202 CKD (Non-Dialysis): Clinical‚ Outcomes‚ and Trials

Authors

  • Sabov, Moldovan, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Denic, Aleksandar, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Mullan, Aidan F., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Kline, Timothy L., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Rule, Andrew D., Mayo Clinic Minnesota, Rochester, Minnesota, United States
Background

Simple kidney cysts are common and usually considered of limited clinical relevance. They are associated with older age and lower glomerular filtration rate (GFR), but little is known of their prognostic utility for progressive chronic kidney disease (CKD) or end-stage kidney disease (ESKD).

Methods

We studied patients with a pre-surgical CT or MRI imaging who underwent a radical nephrectomy for a tumor between 2000 and 2019 and who had no cancer recurrence at least 4 months after nephrectomy. We reviewed the retained kidney images to characterize the number, size, and location of any parenchymal cysts. Cox models to assess the risk of ESKD defined as dialysis, kidney transplantation, or eGFR<10 ml/min/1.73 m2 or CKD progression (ESKD or a 40% decline from postnephrectomy baseline eGFR). Models were adjusted for baseline age, sex, body mass index, hypertension, diabetes, eGFR, proteinuria, and tumor volume.

Results

There were 1237 patients (mean age 64 years; postnephrectomy baseline eGFR 48.4 ml/min/1.73 m2 with 128 progressive CKD events and 26 ESKD events over a median 4.3 years of follow-up. In the cohort, 42% had any kidney cyst and the mean ± SD number of cysts was 0.9 ± 1.7 and diameter of largest cyst was 1.9 ± 1.8cm. Higher number of cysts (but not diameter of largest cyst) predicted both CKD progression and ESKD. The risk of both progressive CKD and ESKD was strongest with presence and number of medullary cysts.

Conclusion

Detection and number of cysts in the kidney, and in particular the medulla, may be useful imaging biomarker beyond current clinical evaluations for predicting risk of progressive CKD and ESKD.