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08-12-2023 | Acromegaly

The prevalence and associated risk factors of detectable renal morphological abnormalities in acromegaly

Authors: Hayri Bostan, Muhammed Kizilgul, Murat Calapkulu, Hatice Kozan Kalkisim, Fatma Betul Gulden Topcu, Umran Gul, Hakan Duger, Sema Hepsen, Bekir Ucan, Erman Cakal

Published in: Pituitary | Issue 1/2024

Abstract

Purpose

The aim of this study was to investigate the prevalence of simple renal cysts (SRCs) and kidney stone disease (KSD) together with laboratory data in patients with acromegaly through comparisons with healthy subjects, and to examine the possible risk factors associated with these abnormalities in acromegaly.

Methods

This retrospective, single-center study included 125 acromegaly patients (46.4 ± 11.6 years, 68 females/57 males) and 114 age-sex matched healthy individuals (45.3 ± 12.4 years, 59 females/55 males). Demographic data, clinical history, biochemical and abdominal/urinary system ultrasonographic data of the patients were reviewed.

Results

The SRC prevalence (28.8% vs. 8.8%, p < 0.001) and the longitudinal and transverse lengths of kidneys (p < 0.05) were significantly higher in patients with acromegaly compared to the control group. The presence of acromegaly was determined to increase the risk of SRC formation 12.8-fold. The prevalence of KSD was similar in both the patient and control groups (15.2% vs. 7.9%, p = 0.08). Patients with acromegaly with renal cysts (n = 36) compared to the group without cysts (n = 89) were older, had a higher male gender frequency, a longer pre-diagnosis symptom duration, and a higher incidence of hypertension and diabetes mellitus at the time of diagnosis. The multivariate logistic regression analysis showed that only advanced age and male gender were associated risk factors for SRCs in acromegaly patients.

Conclusion

The results of this study showed that acromegaly disease significantly increased the prevalence of SRCs and kidney length compared to the age-sex matched healthy population, while the prevalence of KSD was similar. Advanced age and male gender were seen to be independent risk factors for SRC formation in patients with acromegaly.

Fleseriu M, Langlois F, Lim DST, Varlamov EV, Melmed S (2022) Acromegaly: pathogenesis, diagnosis, and management. Lancet Diabetes Endocrinol 10(11):804–826. https://doi.org/10.1016/S2213-8587(22)00244-3CrossRefPubMed

Kamenický P, Mazziotti G, Lombès M, Giustina A, Chanson P (2014) Growth hormone, insulin-like growth factor-1, and the kidney: pathophysiological and clinical implications. Endocr Rev 35(2):234–281. https://doi.org/10.1210/er.2013-1071CrossRefPubMed

Simms RJ, Ong AC (2014) How simple are ‘simple renal cysts’? Nephrol Dial Transplant 29(Suppl 4):iv106–112. https://doi.org/10.1093/ndt/gfu106CrossRefPubMedPubMedCentral

Khan SR, Pearle MS, Robertson WG, Gambaro G, Canales BK, Doizi S, Traxer O, Tiselius HG (2016) Kidney stones. Nat Rev Dis Primers 2:16008. https://doi.org/10.1038/nrdp.2016.8CrossRefPubMedPubMedCentral

Chang CC, Kuo JY, Chan WL, Chen KK, Chang LS (2007) Prevalence and clinical characteristics of simple renal cyst. J Chin Med Assoc 70(11):486–491. https://doi.org/10.1016/S1726-4901(08)70046-7CrossRefPubMed

Suher M, Koc E, Bayrak G (2006) Simple renal cyst prevalence in internal medicine department and concomitant Diseases. Ren Fail 28(2):149–152. https://doi.org/10.1080/08860220500530841CrossRefPubMed

Mensel B, Kühn JP, Kracht F, Völzke H, Lieb W, Dabers T, Lorbeer R (2018) Prevalence of renal cysts and association with risk factors in a general population: an MRI-based study. Abdom Radiol 43(11):3068–3074. https://doi.org/10.1007/s00261-018-1565-5CrossRef

Yamamoto M, Matsumoto R, Fukuoka H, Iguchi G, Takahashi M, Nishizawa H, Suda K, Bando H, Takahashi Y (2016) Prevalence of simple renal cysts in acromegaly. Intern Med 55(13):1685–1690. https://doi.org/10.2169/internalmedicine.55.6560CrossRefPubMed

Auriemma RS, Galdiero M, De Martino MC, De Leo M, Grasso LF, Vitale P, Cozzolino A, Lombardi G, Colao A, Pivonello R (2010) The kidney in acromegaly: renal structure and function in patients with acromegaly during active Disease and 1 year after Disease remission. Eur J Endocrinol 162(6):1035–1042. https://doi.org/10.1530/EJE-10-0007CrossRefPubMed

10.

Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J, CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150(9):604–612. https://doi.org/10.7326/0003-4819-150-9-200905050-00006CrossRefPubMedPubMedCentral

11.

Whelan TF (2010) Guidelines on the management of renal cyst disease. Can Urol Assoc J. 2010 4(2):98–99. https://doi.org/10.5489/cuaj.10023

12.

Kopchick JJ, Bellush LL, Coschigano KT (1999) Transgenic models of growth hormone action. Annu Rev Nutr 19:437–461. https://doi.org/10.1146/annurev.nutr.19.1.437CrossRefPubMed

13.

Doi T, Striker LJ, Gibson CC, Agodoa LY, Brinster RL, Striker GE (1990) Glomerular lesions in mice transgenic for growth hormone and insulinlike growth factor-I. I. relationship between increased glomerular size and mesangial sclerosis. Am J Pathol 137(3):541–552PubMedPubMedCentral

14.

Timsit J, Riou B, Bertherat J, Wisnewsky C, Kato NS, Weisberg AS, Lubetzki J, Lecarpentier Y, Winegrad S, Mercadier JJ (1990) Effects of chronic growth hormone hypersecretion on intrinsic contractility, energetics, isomyosin pattern, and myosin adenosine triphosphatase activity of rat left ventricle. J Clin Invest 86(2):507–515. https://doi.org/10.1172/JCI114737CrossRefPubMedPubMedCentral

15.

Feld S, Hirschberg R (1996) Growth hormone, the insulin-like growth factor system, and the kidney. Endocr Rev 17(5):423–480. https://doi.org/10.1210/edrv-17-5-423CrossRefPubMed

16.

Kawaguchi H, Itoh K, Mori H, Hayashi Y, Makino S (1991) Renal pathology in rats bearing tumour-secreting growth hormone. Pediatr Nephrol 5(4):533–538. https://doi.org/10.1007/BF01453696CrossRefPubMed

17.

Wu Q, Ju C, Deng M, Liu X, Jin Z (2022) Prevalence, risk factors and clinical characteristics of renal dysfunction in Chinese outpatients with growth simple renal cysts. Int Urol Nephrol 54(7):1733–1740. https://doi.org/10.1007/s11255-021-03065-5CrossRefPubMed

18.

Fragiadaki M, Lannoy M, Themanns M, Maurer B, Leonhard WN, Peters DJ, Moriggl R, Ong AC (2017) STAT5 drives abnormal proliferation in autosomal dominant polycystic Kidney Disease. Kidney Int 91(3):575–586. https://doi.org/10.1016/j.kint.2016.10.039CrossRefPubMed

19.

Giustina A, Mazziotti G, Canalis E (2008) Growth hormone, insulin-like growth factors, and the skeleton. Endocr Rev 29(5):535–559. https://doi.org/10.1210/er.2007-0036CrossRefPubMedPubMedCentral

20.

Piskinpasa ME, Piskinpasa H (2022) Bone biochemical markers in acromegaly: an association with Disease activity and gonadal status. North Clin Istanb 9(1):74–81. https://doi.org/10.14744/nci.2020.35467CrossRefPubMedPubMedCentral

21.

Kamenický P, Blanchard A, Gauci C, Salenave S, Letierce A, Lombès M, Brailly-Tabard S, Azizi M, Prié D, Souberbielle JC, Chanson P (2012) Pathophysiology of renal calcium handling in acromegaly: what lies behind hypercalciuria? J Clin Endocrinol Metab 97(6):2124–2133. https://doi.org/10.1210/jc.2011-3188CrossRefPubMed

22.

Muslumanoglu AY, Binbay M, Yuruk E, Akman T, Tepeler A, Esen T, Tefekli AH (2011) Updated epidemiologic study of urolithiasis in Turkey. I: changing characteristics of urolithiasis. Urol Res 39(4):309–314. https://doi.org/10.1007/s00240-010-0346-6CrossRefPubMed

23.

Heilberg IP, Czepielewski MA, Ajzen H, Ramos OL, Schor N (1991) Metabolic factors for urolithiasis in acromegalic patients. Braz J Med Biol Res 24(7):687–696PubMed

24.

Ząbkowski T, Durma AD, Grabińska A, Michalczyk Ł, Saracyn M (2023) Analysis of nephrolithiasis treatment in highest reference hospital-occurrence of acromegaly in the study group. J Clin Med 12(12):3879. https://doi.org/10.3390/jcm12123879CrossRefPubMedPubMedCentral

Title: The prevalence and associated risk factors of detectable renal morphological abnormalities in acromegaly
Authors: Hayri Bostan
Muhammed Kizilgul
Murat Calapkulu
Hatice Kozan Kalkisim
Fatma Betul Gulden Topcu
Umran Gul
Hakan Duger
Sema Hepsen
Bekir Ucan
Erman Cakal
Publication date: 08-12-2023
Publisher: Springer US
Keywords: Acromegaly
Urolithiasis
Published in: Pituitary / Issue 1/2024
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI: https://doi.org/10.1007/s11102-023-01370-z

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