양측 신절제술을 시해한 다낭신질환 1 예

A 43-year-old man in long-term hemodialysis had been suffering from chronic flank pain caused by massively enlarged polycystic kidney disease. Both flank pain was not improved by analgesic therapy and he complained disabling symptoms including marked fatigue and anorexia. Computed tomographic scanning of the abdomen showed bilateral enlarged kidneys occupying most of the abdomen and extending into the pelvic cavity. As the patient's state was not improved by conservative therapy, bilateral nephrectomy was performed. The kidneys had 27 cm in length and 6.8 kg in weight both. Pathological examination on nephrectomized kidneys showed interstitial nephritis, hyaline degeneration and proliferative change of glomeruli, microabscess of tubules.In patients with painful huge polycystic kidney who have failed medical management, surgical nephrectomy may be a reasonable option. Surgical decompressive therapy provide long-term pain relief in the majority of patients but bilateral nephrectomy may also considered in selected cases. The comparison of effects between both options requires more experiences.(Korean J Med 59:343-346, 2000)