Clinical characteristics of bladder cancer identified by multi-detector computed tomography in patients with asymptomatic isolated hematuria / 대한내과학회지

BACKGROUND/AIMS: This report discusses the frequency and clinical characteristics of bladder cancer diagnosed with multi-detector computed tomography (MDCT) in outpatients visiting a nephrology and urology clinic with asymptomatic isolated hematuria. METHODS: MDCT was performed on outpatients who presented to the nephrology and urology clinic at the Holy Family Hospital of the Catholic University of Korea with asymptomatic isolated hematuria from January 2005 to December 2007. RESULTS: Of the 1,819 patients who underwent MDCT, the results were normal in 54.1%, showed a simple renal cyst in 25.7%, a renal calculus in 4.7%, and a malignant tumor of the urinary tract in 1.7%. Twenty-five patients (1.3%) were diagnosed with bladder cancer, including 20 (80%) men and 5 (20%) women. The average age of the patients with bladder cancer was 74.5+/-7.3 years. The 25 patients diagnosed with bladder cancer had a higher rate of gross hematuria, older age, and male gender (p<0.05) compared to the other patients. In addition, their hemoglobin and albumin levels were significantly lower (p<0.05). For all patients, the frequency of bladder cancer in those with asymptomatic microscopic hematuria, excluding those with gross hematuria, was extremely low (0.3%, 6 patients). CONCLUSIONS: MDCT may constitute an adequate diagnostic test for patients with asymptomatic hematuria. Older male patients with gross hematuria require a thorough urologic evaluation.

Clinical Usefulness of Multi-Detector Computed Tomography in Diagnosis of Patients with Microscopic Hematuria / 대한신장학회지

PURPOSE: The number of patients with microscopic hematuria has increased for etiological reasons. The first diagnostic step for microscopic hematuria is usually intravenous pyelography (IVP). Nowadays, multi-detector computerized tomography urography (MDCT urography), which can evaluate the whole urinary tract, has been widely used. The objective of this study was to investigate the clinical usefulness of MDCT urography for diagnosis of microscopic hematuria in comparison with IVP. METHODS: 510 patients were selected randomly and underwent MDCT urography or IVP from October 2004 to September 2006 (MDCT 267 patients, IVP 243 patients). RESULTS: In 267 cases of MDCT urography, normal 158 (59%), simple renal cyst 75 (28%), renal stone 14 (5.3%), ureteral stone 8 (3%), and malignancy 7 (2.6%) (renal cell carcinoma 2, transitional cell carcinoma of ureter 2, bladder cancer 3) were detected. In 243 cases of IVP, normal 221 (91%), simple renal cyst 3 (1.2%), renal stone 4 (1.6%), ureteral stone 7 (2.9%), and malignancy 1 (0.4%) were detected. The detection rates of simple cyst, renal stone and urothelial carcinoma in MDCT urography were higher than those of IVP significantly (p<0.05), but the detection rate of ureteral stone between MDCT urography and IVP was not significantly different. CONCLUSION: MDCT urography is a valuable modality for evaluation of patients with microscopic hematuria. It seems to have a high detection rate in simple renal cyst, renal stone, and urethelial carcinoma, although prospective studies for its efficacy are needed.

Chinese Herbs Induced End-Stage Renal Disease in a Patient with Minimal Change Nephrotic Syndrome / 대한신장학회잡지

An outbreak of rapidly progressive renal failure was observed in Belgium in 1993 and was related to a slimming regimen involving Chinese herbs. Extensive interstitial fibrosis with atrophy and tubular loss was the major histological lesion. Aristolochic acid has been suspected to be responsible for nephrotoxicity. The use of Chinese herbal medicines is very popular in Korea. We report the presence of a nephrotoxic compound in herb medications, which led to end-stage renal failure in a patient with complete remission state of minimal change disease. The typical and sequential pathologic changes in our patient following the consumption of herbs suggest possible relationship to herbal medicines, and end-stage renal disease, despite the fact that a cause-and-effect relationship cannot be automatically inferred.