Acquired Cystic Disease of the Kidneys and Renal Cell Carcinoma in Chronic Renal Insufficiency without Dialysis Treatment

Abstract

We report 3 cases of acquired cystic disease of the kidneys with associated renal carcinoma in 2 of the cases. In all 3 cases, the patients had chronic renal insufficiency due to hypertension but had never required dialysis. Review of 176 reported cases of acquired cystic disease of the kidneys and renal tumors disclosed that 18 patients (including 1 previously reported by us) had never received dialysis treatment. These cases support the hypothesis that acquired cystic disease of the kidney is not restricted to patients treated with maintenance dialysis. Among the 18 patients, hypertension was the most common underlying cause of renal failure. Patients with chronic renal failure due to or associated with severe hypertension should be monitored carefully for the development of both renal cysts and tumors even though they have not started on chronic dialysis.

Renal cell carcinoma co-existent with other renal disease: clinico-pathological features in pre-dialysis patients and those receiving dialysis or renal transplantation

“…As other studies, this study confirms that ACKD is not restricted to patients undergoing RRT, since it also develops in those with chronic renal disease but not on dialysis [10]. Irrespective of the original renal disease, ACKD may predispose to RCC not only in dialysis and transplanted patients, but also in those who have chronic renal disease before the initation of dialysis.…”

“…Although the risk of RCC, especially the papillary type, has been reported to be increased in patients with ACKD-associated CRF who are on dialysis, reports of ACKD and RCC developing in CRF without dialysis treatment are limited [10]. In contrast to RCC in nonuraemic patients, RCC patients with ACKD have a high incidence of papillary RCC.…”

Metastasizing Renal Cell Carcinoma and Acquired Renal Cystic Disease in a Hemodialysis Patient

“…The incidence of adenomas amongst the total number of patients undergoing dialysis is 7.5% [2,3,[8][9][10][11][12]16] and 21 % among patients with ARCD. These percentages are 2.7 and 7.7%, respectively, for those patients with renal cell carcinomas.…”

“…Since then, various publications [2,6,7] have shown that ARCD is indeed a frequent entity and can be found in up to one third of dialysis patients. [2,3,[8][9][10][11][12][13][14][15][16].…”

“…For some of those who have carried out studies, the most important determining factor in renal cystic trans formation is the length of time spent undergoing dialysis [7,17,18], with figures of 43% after 3 years and 90% after 9 years [8], although it has also been found in ESRD patients who were not undergoing dialysis [9][10][11]. Whether or not the disease regresses following renal transplantation is a controversial question [7,19], Other predisposing factors, described in publications, are: be ing of the male sex [4,17], being elderly [3,4,17], having glomerular [6,8] or hypertensive etiology [3], and like wise having analgesic nephropathy [7], Perhaps one of the most significant aspects of this entity, however, is that which refers to its possible neo plastic degeneration, represented by both benign tumors (7.5% of cases undergoing dialysis) and malignant tu-mors (2.7%).…”