Involution of Polycystic Kidneys during Replacement Therapy of Terminal Renal Failure

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Abstract
Total kidney volume, i.e., the combined volume of both kidneys (TKV), was determined by computerized tomography (CT scanning) during replacement therapy of terminal renal failure in 12 patients with adult polycystic kidney disease. Mean TKV was 2090 (872-3437) cm3 in 6 of 11 patients with both kidneys in situ, treated for 44 (28-59) mo., and 1184 (308-2761) cm3 in 5, treated for 97 (75-130) mo. The difference is not statistically significant (0.1 > P > 0.05). Two patients, treated for 89 and 130 mo., had a TKV of 308 and 408 cm3, respectively, i.e., almost equal to the normal (303 cm3 SD 29). Six patients, 5 with both kidneys in situ and 1 unilaterally nephrectomized, were examined with 2 CT scans at an interval of 31 (17-46) mo., and all showed a significant decrease in TKV, averaging 0.77 (0.49-1.09)%/mo. of treatment. Apparently, polycystic kidneys undergo involution during replacement therapy, but the gradual shrinkage may be difficult to verify by single volumetric measurements in patients treated for varying periods due to the large interindividual variation in TKV in adult polycystic kidney disease.