Acquired cystic disease of the kidneys: a hazard of long-term intermittent maintenance haemodialysis.

Abstract

In the period 1968-76, necropsies were carried out on 30 patients who had been treated by long-term intermittent maintenance haemodialysis. Fourteen of these patients developed bilateral cystic disease of the kidney. Clinical, pathological, and radiological investigation of these patients when they first presented did not reveal any evidence of renal cystic change. The main complications of this condition are haemorrhage and tumour formation. Six patients developed renal tumours, and in five cases these were multiple. The histological appearance of these neoplasms gave no indication as to whether they would behave in an aggressive manner. One patient died of metastatic carcinomatosis from a renal primary. The condition of acquired cystic disease of the kidney should be suspected if patients on maintenance haemodialysis suffer from recurrent haematuria or are found to have enlarging kidneys.

Renal Cystic Diseases and Renal Neoplasms

“…The first association between RCC and ESKD with ACKD was reported by Dunhill et al in 1977 (85), who described 6 cases in 14 ACKD patients at autopsy (85). This high incidence is definitional; their series included only advanced cases of ACKD.…”

“…This high incidence is definitional; their series included only advanced cases of ACKD. Numerous studies of ACKD in the dialysis population have shown that the incidence of ACKD is proportional to dialysis interval, with close to 100% of patients affected by 10 yr of dialysis (85)(86)(87)(88)(89)(90)(91)(92)(93)(94). Renal transplantation seems to reduce the incidence of ACKD (95).…”

Hiperplasia embrionária epitelial da cápsula de Bowman pós-diálise crônica simulando nefroblastomatose: relato de caso

“…Sua apresentação mais comum se faz sob a forma de doenças císticas adquiridas, descritas pela primeira vez por Dunnil et al (2).…”

Heterochronic Spontaneous Rupture of Bilateral Renal Cell Carcinomas in a Hemodialysis Patient

“…RCCs occurring in hemodialysis patients are often accompanied by acquired cystic disease of the kidney (ACDK) (2), which increases in prevalence with increasing duration of dialysis and appears to be an origin of RCC (3). Patients with RCC typically present with symptoms such as macroscopic hematuria, flank pain and fever; however, few patients present with all three symptoms.…”