Angiographic diagnosis of polycystic renal disease

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POLYCYSTIC disease of the kidney usually presents no difficulty in diagnosis. The presence of arterial hypertension, palpable kidneys, family history of renal disease, various degrees of renal insufficiency, and urographic and pyelographic evidence of multiple, bilateral renal masses establish the diagnosis in the majority of patients. Problems in diagnosis arise when the combination of findings is absent.1 In this problem group are those patients with arterial hypertension, or renal insufficiency, or both; those relatively symptom-free but with minor abnormalities disclosed by intravenous urography or retrograde pyelography; and those thought to have renal tumors or solitary cysts from evidence on pyelograms.

The contribution of selective renal angiography to the diagnosis of polycystic renal disease is the subject of this report. For the purpose of this series, polycystic disease is defined as a familial and probably congenital pathologic process in which numerous cysts are located diffusely throughout the renal parenchyma of both kidneys, often associated with arterial hypertension, various degrees of renal insufficiency, and occasionally cystic disease of the liver. An elaborate distinction between so-called multicystic disease and polycystic renal disease is not included in this report.

Materials and Methods

From a series of 1,500 selective renal arteriograms, a diagnosis of polycystic renal disease was established in 14 patients. These patients each had been studied because of a suspected renal mass (not polycystic disease), for the evaluation of arterial hypertension or of uremia or of both disorders. In some instances urographic abnormalities had prompted the angiographic study.

All patients were studied by . . .



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