| Abstract | Cistična bolest bubrega je heterogena skupina bolesti koju karakterizira rast i razvoj
cista u bubrezima. Ciste mogu utjecati na funkciju bubrega i rezultirati njegovim zatajenjem te
nadomještanjem bubrežne funkcije dijalizom ili transplantacijom bubrega. Ciste se dijele na
jednostavne ili složene, a cistične bolesti bubrega na prirođene ili stečene. Od prirođenih
cističnih bolesti najčešća je autosomno dominantna policistična bolest bubrega, dok su ostale
bolesti rjeđe. Stečene cistične bolesti bubrega povezane su sa starenjem, hormonskim
promjenama, primjenom lijekova, kroničnim bubrežnim bolestima i dijalizom. Jednostavne
ciste čest su nalaz u zdravim i normalnim bubrezima, a njihova pojava raste s dobi. Za razliku
od jednostavnih cista koje su dobroćudne i obično asimptomatske, složene ciste povezane su
zloćudnim neoplazmama te je potrebno njihovo praćenje i/ili kirurško liječenje. Kliničke
manifestacije cistične bolest bubrega mogu biti asimptomatske, ali i po život opasne. Dijele se
na bubrežne i izvanbubrežne manifestacije. Bubrežne su akutna i kronična bol, arterijska
hipertenzija, nefrolitijaza, hematurija, infekcije mokraćnog sustava i kronična bubrežna bolest
stadija 1-5. Kod autosomno dominantne policistične bolesti bubreg ciste se mogu razviti u jetri,
gušterači i drugim organima pa će time i izvan bubrežne manifestacije ovisiti o tome koji je
organ zahvaćen cistama i utječu li one na funkciju organa. Osim toga, ovom bolesti može biti
zahvaćen i srčano žilni sustav, a najčešća je i po život potencijalno opasna manifestacija
intrakranijalna aneurizma. Dijagnostika bubrežnih cista temelji se na slikovnim metodama:
ultrazvuku, kompjuteriziranoj tomografiji ili magnetskoj rezonanciji. Liječenje je nespecifično
i uključuje nefarmakološke i farmakološke mjere: izbjegavanje potencijalnih rizičnih
čimbenika progresije bubrežne bolesti, kontrolu arterijskog tlaka, liječenje boli i infekcija,
praćenje i liječenje izvan bubrežnih manifestacija bolesti. Dijaliza i transplantacija bubrega
jedine su terapijske mogućnosti u završnom stadiju kronične bubrežne bolesti. |
| Abstract (english) | Cystic kidney disease is a heterogeneous group of diseases characterised by the growth
and development of kidney cysts. Cysts may affect renal function and result in its failure,
thereby prompting replacement of kidney function by dialysis or kidney transplantation. Cysts
are categorized as simple or complex, and cystic kidney diseases as congenital or acquired.
Autosomal dominant polycystic kidney disease is the most common congenital cystic kidney
disease, while other diseases are less frequent. Acquired cystic renal diseases are associated
with aging, hormonal changes, drug use, chronic kidney disease and dialysis. Simple cysts are
commonly found in healthy and normal kidneys, and the occurrence increases with age. Unlike
simple cysts, which are benign and usually asymptomatic, complex cysts are associated with
malignant neoplasms and require monitoring and/or surgical treatment. Clinical manifestations
of cystic kidney disease can be asymptomatic, but also life threatening. Manifestations are
divided into renal and extrarenal manifestations. Renal manifestations include acute and
chronic pain, hypertension, nephrolithiasis, hematuria, urinary tract infections and chronic
kidney disease stages 1-5. In autosomal dominant polycystic disease cysts may occure in the
liver, pancreas and other organs, so the extrarenal manifestations will depend on which organ
is affected by cysts and their effects on organs function. In addition, cardiovascular system can
be affected by this disease, and the most common life-threatening manifestation is intracranial
aneurysm. Diagnosis of renal cysts is based on imaging methods: ultrasonography,
computerized tomography, or magnetic resonance imaging. The treatment is nonspecific and
includes nonpharmacological and pharmacological measures: avoiding potential risk factors for
progression of kidney disease, blood pressure control, pain and infection treatment, monitoring
and treatment of extrarenal manifestations. Dialysis and kidney transplantation are the only
therapeutic options in the terminal phase of chronic kidney disease. |
