대한신장학회

논문분류	춘계학술대회 초록집
제목	Height-Adjusted Total Liver Volume Affects Abdominal Symptoms and Nutritional Status in ADPKD Patients
저자	Hyun Jin Ryu1, Hyunsuk Kim1, Hayne Cho Park1, Hyunhwa Jang1, Eun Joo Joe1,Hyungah Jo1, Kook-Hwan Oh1, Young-Hwan Hwang2, Curie Ahn1
출판정보	2014; 2014(1):
키워드	상염색체우성다낭신질환, 영양, 다낭성간질환
초록	Introductions and Aims: Polycystic liver has not been received much attention as a treatment target because it is often asymptomatic. However, as liver cyst grows, it occasionally results in serious morbidity and mortality. We investigated the effect of height-adjusted total liver volume (htTLV) on abdominal symptoms and nutritional status in autosomal dominant polycystic kidney disease (ADPKD) patients with polycystic liver. Methods: We conducted a cross-sectional study with ADPKD patients who were registered at PKD clinic in Seoul National University Hospital. TLV was measured by stereotactic volumetry using abdominal computed tomography (CT) scan and adjusted by the height. We evaluated chronic symptoms related to hepatic cysts by questionnaire and identified complications by medical record review. Subjective global assessment (SGA) was performed to assess nutritional status. The clinical and anthropometric risk factors were analyzed according to htTLV (group 1 ≥1,800 mL/m vs. group 2 <1,800 mL/m). Results: A total of 112 patients (54 male, 58 female) were included in the analysis. Mean age was 51 years and their mean eGFR was 57.9±24.5 mL/min/1.73m2. Mean htTLV was 1320.6±870.3 mL/m and mean htTKV was 902.5±551.1 mL/m, respectively. Group 1 (n=15) was older (55.5±8.3 vs. 50.5±11.9 years old, p=0.077), had higher female proportion (73.3% vs. 48.5%, p=0.073), lower plasma hemoglobin level (12.2±0.7 vs. 13.3±1.6 g/dL, p=0.003), lower mean estimated GFR (46.5±15.9 vs. 59.7±25.2 ml/min/1.73m2, p=0.066), and larger htTKV (1285.3±23.4 vs. 843.3± 472.3 mL/m, p=0.03) than group 2 (n=97). The most common symptom was back pain (61.9%) followed by flank pain (52.4%). Group 1 showed a higher prevalence of early satiety (66.7% vs. 18.1%, p=0.001), mass sensation (58.3% vs. 23.6%, p=0.033), and abdominal fullness (91.7% vs. 44.4%, p=0.002). In addition, group 1 showed lower SGA score compared to group 2 (5.7±1.1 vs. 6.5±0.6, p=0.002). Conclusions: ADPKD patients with large htTLV showed more frequent chronic abdominal symptoms and poor nutritional status. Chronic symptoms and nutritional risk must be considered when deciding treatment modality for polycystic liver.
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