Acquired cystic disease: Replacing one kidney disease with another

Abstract

This high prevalence of acquired cystic kidney disease in dialysis patients suggests that it is the natural consequence of most sclerosing renal disease in patients who survive unnaturally. Flank pain and hematuria are the principal symptoms, but, fortunately, these occur in only a small percentage of dialysis patients. Thus, ACKD does not appear to be a major cause of dialysis morbidity. On the other hand, 16.4% of patients with ACKD have renal tumors, the malignant potential of which is illustrated by metastases in several patients. Although relatively small, the number of cases reviewed here raises concerns about the long-term consequences of leaving end-stage kidneys undisturbed in dialysis patients. A controlled survey of the morbidity of ACKD and of the frequency of renal carcinoma in dialysis patients is needed urgently.