Study On The Influencing Factors Of Renal Insufficiency In Patients With Simple Renal Cysts

Objective: To investigate whether the cyst harmed the renal function or not in simple renal cyst(SRC).Then analyzing the influencing factors of SRC on renal function comprehensively,which was candidated for directing the diagnosing and treatment for SRC.Methods: After computer retrieval related database and case-control study collected about the damage of SRC on renal function,the literature analysis with Stata 12.0software were performed after literature filtering and extraction.Meta-analysis of Scr and GFR were performed to determine whether there was a damage on kidney.Retrospective analysis of 54 cases of SRC who were admitted in our hospital from Dec 2014 to Dec 2016.Patients who had performed dynamic imaging examination with 99 m Tc-DTPA were included,while merging other kidney,systemic disease or multiple renal cysts were excluded and there were 30 for studying.The GFR results of dynamic image were used to estimate renal function.Collecting their clinical basic information and remembering that the GFRc for GFR of renal side and GFRn for normal side,total GFR(GFRc+n)was equal to the adding of bilateral GFR(GFRc+n =GFRn + GFRc).Statistical analysis was used to evaluate if there was a difference on both sides.Performing the correlation and regression analysis of GFR with gender,age,body mass index(BMI),blood sugar,blood uric acid,blood pressure(systolic pressure),cyst location(outer convex or invagination),and the diameter of renal cyst.Analyzing the influence factors of SRC for renal function.With the same analyzing method to evaluate the influencing factors of systolic pressure(SBP)in SRC patients.Results:1.After literature review,106 related references were screened.Excluding 100articles which didn’t conform to study destination,methods or the reduplicated published papers,there were 6 articles for Meta-analysis.Compared with normal group,the Scr(Z=3.16,P=0.002)was higher and GFR(Z=2.63,P=0.009)was lower in cysts group,which showed that there was statistic difference between normal person and the patient with SRC.2.After matching t-test of bilateral GFR for 30 patients,the GFR was lower in cyst side than normal side.The results suggested that there was difference of GFR in bilateral kidney.3.Performing the correlation analysis of GFRc+n with gender,age,body mass index(BMI),blood sugar,blood uric acid,blood pressure,cyst location and the diameter of renal cyst,the results showed that age and SBP associated with GFRc+n respectively.Then the multiple linear regression of GFRc+n with age,SBP,cyst location and diameter showed that only age(t=-3.416,P=0.002)and SBP(t=-2.579,P=0.016)had a linear negative correlation with GFRc+n.Performing the correlation and regression of GFRc and SBP with the same analyzing methods respectively,the results showed that age(t=2.486,P=0.001)was linear negative correlation with the GFRc while the blood sugar(t=2.136,P=0.005)positive.Gender(male,t=-2.356,P =0.026)and GFRc+n(t=-2.582,P=0.016)were linear negative correlation with SBP,while positive in cyst diameter(t=2.707,P=0.012).Conclusions:1.There was a certain damage of SRC for renal function.But its relationship was nonlinear,that is when the cyst getting larger while the renal function must not being worse.2.The multiple analysis showed that the total renal function in single SRC was associated with age and SBP,which had a linear negative correlation with total GFR.: the higher in age and SBP,the worse in total kidney function.Then SBP was related to sex and the diameter of renal cyst.Male had a higher SBP,while the larger in the diameter of renal cyst,the higher in SBP,then the lower in renal function.3.The multiple analysis showed that the renal function of cyst side in single SRCwas associated with age and blood sugar.Age had a linear negative correlation with GFRc,while positive in blood sugar.That is,the higher in age and the lower blood sugar,the worse in kidney function of the cyst side.4.Only the diameter of renal cyst could not to be the criterion for whether performing the surgery.The final treatment management should according to the extent of renal function which was evaluated by sex,age,blood sugar and the level of blood pressure comprehensively.