단순 신낭종 유무에 따른 사구체 여과율의 차이
Glomerular Filtration Rate Difference between Renal Cyst Group and Control Group
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연구배경: 단순 신낭종은 성인에서 가장 흔히 볼 수 있는 낭성기형으로 대부분 임상적 증상이 없어 건강검진에서 우연히발견되는 경우가 많다. 본 연구는 건강검진 중 복부 초음파 검사를 받은 수검자를 대상으로 단순 신낭종이 발견된 군과 발견되지 않은 대조군의 임상적 차이를 비교하고자 하였다. 방법: 일개 대학병원 종합건강증진센터에서 건강검진을 받은 수검자 가운데 2,277명을 무작위로 선정하여 단순 신낭종이 있는 188명과 성별, 나이, 체질량 지수를 각각 짝지은 대조군 188명을 대상으로 하였다. 수검자들의 의무기록을 검토하여 얻은 성, 나이, 질병의 과거력, 사회력, 복부 초음파 검사, 소변검사, 혈액검사 결과를 이용하여 단순 신낭종이 고혈압, 신기능 저하, 현미경적 혈뇨 등과 관련이 있는지 대조군과 비교해 보았다. 결과: 총 2,213명 중 189명(8.5%)에서 단순 신낭종이 발견되었다. 낭종의 수가 3개 이상인 사람은 나이에 따라 차이가 있었고(P=0.05), 70대 이상에서 가장 많았다. 단순 신낭종이 있는군에서 고혈압 유병률이 높았고(29.8% vs. 20.7%, P=0.05) 현미경적 혈뇨가 더 많았으며(14.9% vs. 6.9%, P=0.02) 혈청 크레아티닌치가 높았고(0.97 mg/dL vs. 0.91 mg/dL, P=0.02), 사구체여과율은 낮았다(83.56 mL/min vs. 95.03 mL/min, P<0.01). 결론: 단순 신낭종은 남성에게 많이 발생하였고, 나이가 증가함에 따라 낭종의 크기와 개수가 증가하는 경향을 보였다. 또한 단순 신낭종이 있는 군에서 고혈압의 유병률이 높았고, 현미경적 혈뇨의 빈도가 많았으며, 신기능이 낮았다. 단순 신낭종이 있는 경우, 복부 초음파 검사를 통한 크기나 모양 변화 관찰 외에도 고혈압, 신기능 저하, 현미경적 혈뇨 등에 대한 경과관찰이 필요할 것으로 생각된다.
Abstract
Background: The simple renal cyst is the most prevalent cystic deformation in adults and is most of them are incidentally found during medical examination. In this study, the clinical differences were compared between simple renal cyst and control groups diagnosed by abdominal ultrasonography during periodic medical examination. Methods: We randomly selected 2,277 persons who took medical examination in one general hospital health promotion center. Among them, analysis was conducted for 188 subjects with simple renal cyst and 188 subjects without renal cyst whose sex, age, and body mass index were matched. Renal cyst subjects were compared with control group to search for their relationship with hypertension, renal function and microscopic hematuria, past medical history, social history,results of other abdominal ultrasonography findings, urine test, and blood test. Results: Among 2,213 subjects, simple renal cyst was found in 188 subjects (8.5%). The subjects who had more than three simple renal cysts were significant older (P = 0.05) and the oldest age was 70's. Also, higher hypertension prevalence (P = 0.05), more microscopic hematuria, higher serum creatinine (P = 0.02), and lower glomerular filtration rate (P < 0.01)were observed in simple renal cyst group. Conclusion: It is needed to survey size, shape and change of simple renal cyst using abdominal ultrasonography as well as how its progression may be related to developing hypertension, decreased renal function and microscopic hematuria.
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