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June 10, 1974

Cystic Disease of the Renal Medulla in the Elderly

Author Affiliations

From the departments of medicine (Dr. Swenson), pathology (Dr. Kempson), and radiology (Dr. Friedland), Stanford University School of Medicine, and the Veterans Administration Hospital (Dr. Swenson), Palo Alto, Calif. Dr. Swenson is the recipient of a Clinical Investigator Award from the Veterans Administration.

JAMA. 1974;228(11):1401-1404. doi:10.1001/jama.1974.03230360031019

A 68-year-old woman with uremia and "renal salt wasting" improved greatly with sodium repletion. Several family members had died of renal failure. Multiple, bilateral corticomedullary cysts were seen on high-dose excretory urography with nephrotomography. A 67-year-old brother with normal urinalysis and creatinine clearance values also showed corticomedullary cysts on excretory urography. Despite long-term sodium supplementation, uremia progressed inexorably and death occurred 3 1/4 years after clinical onset of disease. Cystic disease of the renal medulla was confirmed at time of autopsy. The triad of a positive family history, renal salt wasting, and progressive chronic uremia strongly suggests the diagnosis of cystic disease of the renal medulla, irrespective of the age of the patient.

(JAMA 228:1401-1404, 1974)