Acquired cystic kidney disease
Updates to Article Attributes
Acquired cystic kidney disease (ACKD) is a condition that may be observedoccurs in those patients withpatients with end-stage kidney disease (ESKD), especially patients when on dialysis treatment, and who do not have a history history of hereditary other cystic renal disease.
Epidemiology
Its incidence increases with the amount of time a patient is azotemic and has been estimated at 44% after three years of dialysis and 90% after 10 years of dialysis 6. It is equally as common with haemodialysis as with peritoneal dialysis2.
Clinical presentation
Usually asymptomatic. Cyst haemorrhage may may cause flank pain and haematuria 2.
Pathology
Although ureaemia is associated with eventual development of acquired acquired cystic kidney disease, the pathogenesis is currently unknown. Some theories suggest that toxins or accumulation of growth factors, such as epidermal growth factor.
The hyperplastic renal cysts in ARCD have been considered a possible source of of dialysis-associatedrenal cell carcinoma.
Radiographic features
Classical imaging features include small renal cysts, occurring in both the cortex and medulla, which are found bilaterally, with both kidneys typically being small in size (refer on chronic kidney disease (CKD) article for a broad discussion on its correlated imaging findings).
Diagnostic criteria includes
- patients with chronic renal failure
- kidneys are usually decreased in size
- >3-5 cysts in each kidney
- cysts are mostly cortical, but may also be medullary
Treatment and prognosis
Renal transplantation has been thought to resolve acquired acquired renal cysts, but there is still a risk of RCC in the native kidneys.
Complications
- haemorrhage into cysts, which occurs occasionally
- development ofrenal cell carcinoma, which occurs in ~7%
- imaging screening for these patients is controversial3,4,5
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One;55Y;55 years old who have been on dialysis for three years 3
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- imaging screening for these patients is controversial3,4,5
History and etymology
ACKD was first described in 1977 by M. S. DunnilMS Dunnil et al. 3,4.
-<p><strong>Acquired cystic kidney disease (ACKD)</strong> is a condition that may be observed in those patients with <a href="/articles/end-stage-kidney-disease">end-stage kidney disease (ESKD)</a>, especially patients on dialysis treatment, and who not have a history of hereditary cystic disease. </p><h4>Epidemiology</h4><p>Its incidence increases with the amount of time a patient is azotemic and has been estimated at 44% after three years of dialysis and 90% after 10 years of dialysis <sup>6</sup>. It is equally as common with haemodialysis as with peritoneal dialysis <sup>2</sup>.</p><h4><span style="font-size:1.5em; line-height:1em">Clinical presentation</span></h4><p>Usually asymptomatic. Cyst haemorrhage may cause flank pain and haematuria <sup><span style="font-size:10.8333330154419px; line-height:17.3333320617676px">2</span></sup>.</p><h4>Pathology</h4><p>Although ureaemia is associated with eventual development of acquired cystic kidney disease, the pathogenesis is currently unknown. Some theories suggest that toxins or accumulation of growth factors, such as epidermal growth factor.</p><p>The hyperplastic renal cysts in ARCD have been considered a possible source of dialysis-associated <a href="/articles/renal-cell-carcinoma-1">renal cell carcinoma</a>.</p><h4>Radiographic features</h4><p>Classical imaging features include small renal cysts, occurring in both the cortex and medulla, which are found bilaterally, with both kidneys typically being small in size (refer on <a href="/articles/chronic-kidney-disease">chronic kidney disease (CKD)</a> article for a broad discussion on its correlated imaging findings).</p><p>Diagnostic criteria includes</p><ul>- +<p><strong>Acquired cystic kidney disease (ACKD)</strong> is a condition that occurs in patients with <a href="/articles/end-stage-kidney-disease">end-stage kidney disease (ESKD)</a>, especially when on dialysis treatment, and who do not have a history of other <a title="Cystic renal diseases" href="/articles/cystic-renal-diseases">cystic renal disease</a>. </p><h4>Epidemiology</h4><p>Its incidence increases with the amount of time a patient is azotemic and has been estimated at 44% after three years of dialysis and 90% after 10 years of dialysis <sup>6</sup>. It is equally as common with haemodialysis as with peritoneal dialysis <sup>2</sup>.</p><h4>Clinical presentation</h4><p>Usually asymptomatic. Cyst haemorrhage may cause flank pain and haematuria <sup>2</sup>.</p><h4>Pathology</h4><p>Although ureaemia is associated with eventual development of acquired cystic kidney disease, the pathogenesis is currently unknown. Some theories suggest that toxins or accumulation of growth factors, such as epidermal growth factor.</p><p>The hyperplastic renal cysts in ARCD have been considered a possible source of dialysis-associated <a href="/articles/renal-cell-carcinoma-1">renal cell carcinoma</a>.</p><h4>Radiographic features</h4><p>Classical imaging features include small renal cysts, occurring in both the cortex and medulla, which are found bilaterally, with both kidneys typically being small in size (refer on <a href="/articles/chronic-kidney-disease">chronic kidney disease (CKD)</a> article for a broad discussion on its correlated imaging findings).</p><p>Diagnostic criteria includes</p><ul>
-</ul><h4>Treatment and prognosis</h4><p>Renal transplantation has been thought to resolve acquired renal cysts, but there is still a risk of RCC in the native kidneys.</p><h5>Complications</h5><ul>- +</ul><h4>Treatment and prognosis</h4><p>Renal transplantation has been thought to resolve acquired renal cysts, but there is still a risk of RCC in the native kidneys.</p><h5>Complications</h5><ul>
-<li>development of <a href="/articles/renal-cell-carcinoma-1">renal cell carcinoma</a>, which occurs in ~7% <ul><li>imaging screening for these patients is controversial <sup>3,4,5</sup><ul><li>-<sup></sup>One screening strategy images patients <55Y who have been on dialysis for three years <sup>3</sup>- +<li>development of <a href="/articles/renal-cell-carcinoma-1">renal cell carcinoma</a>, which occurs in ~7% <ul><li>imaging screening for these patients is controversial <sup>3,4,5</sup><ul><li>one screening strategy images patients <55 years old who have been on dialysis for three years <sup>3</sup>
-</ul><h4>History and etymology</h4><p>ACKD was first described in 1977 by <strong>M. S. Dunnil</strong> et al. <sup>3,4</sup></p>- +</ul><h4>History and etymology</h4><p>ACKD was first described in 1977 by <strong>MS Dunnil</strong> et al <sup>3,4</sup>.</p>
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