腎臓学と治療学ジャーナル

Polycystic liver disease (PLD) can be autosomal dominant or isolated with no renal impairment. The natural course of liver cysts is for them to grow in size and number, resulting in progressive disease that can lead to extremely large and incapacitating hepatomegaly. Only symptomatic hepatomegaly (pain, inability to eat, weight loss, dyspnea) or cystic complications like infection or intracranial haemorrhage should be treated. PLD treatment thus encompasses a wide range of therapeutic options, from non-intervention to liver transplantation, including needle aspiration evacuation with sclerosant injection, laparoscopic fenestration, and fenestration by laparotomy combined with liver resection. The choice of treatment is determined by the symptomatology, intrahepatic extension of the lesions, and the patient's overall health.

Acute kidney injury (AKI) is a widespread health problem that manifests as a variety of diseases. It has been linked to an increased risk of mortality and, in some cases, progression to chronic kidney disease, particularly in the elderly. AKI is associated with a number of other abnormalities, including metabolic acidosis and changes in body fluid volume. Although the epidemiology of AKI in hospitalised or critically ill populations is well understood and studied, the prevalence in the general emergency department (ED) population is unknown. As a result, acute AKI management and appropriate outpatient followup have not been optimised. This article provides a review of key renal disease principles as well as an evidencebased approach to AKI management in the emergency setting.