Dr. Chada Ramesh, Dr. Kondal Reddy. S, Dr. Rama Enaganti


INTRODUCTION: Cystic kidney disease is a unilateral or bilateral cystic disease characterized by small cysts distributed throughout the renal
cortex and medulla of patients with ESRD unrelated to inherited renal cystic diseases.
ACKD is a disease of chronic renal failure of any etiology and has to be differentiated from other types of cystic kidney disease. It is defined as more
than three macroscopic cysts in each kidney of a patient who does not have a hereditary cause of cystic disease. It can be present at early stages of
CKD or more commonly in patients on dialysis & to a lesser extent in native kidneys of renal transplant recipients. Most of them are asymptomatic
but rarely complications like infection, rupture, bleeding, spontaneous perinephric hematoma may occur There is increased incidence of renal
neoplasms in acquired cystic kidney disease that some authors consider ACKD pre-neoplastic.
Its prevalence and severity are higher in men than in women and increases with the duration of azotemia and duration of dialysis1 as well.
With better health care facilities and penetration of nephrology services, the life span of patients on dialysis is increasing. The easy availability &
application of imaging services to the above group has led to more frequent diagnosis of acquired cystic kidney disease.
AIMS: To study the prevalence of kidney cysts in patients on maintenance hemodialysis.
Ÿ To study correlation between duration of dialysis and cystic changes and complications arising out it.
Ÿ To study the impact of age and gender on cystic changes.
METHODS: The study was done in Maintenance hemodialysis unit of Gandhi Hospital, secunderabad. 140 patients were enrolled over a period of
one year from May,2016 to April,2017. Patients who had past history of polycystic kidney disease and had acquired kidney disease on sonography
prior to dialysis were excluded.
Radiological imaging was done using Computerized tomography KUB to look for acquired renal cysts. Cystic changes were considered as
presence of one or more cysts in either or both the kidneys.
STUDY DESIGN: prospective cross-sectional observational study.
STATISTICAL METHODS: Data analysed using the Statistical Package for Social Science (SPSS) software version 19.
ANOVA test is applied for comparison variables. A P value of < 0.05 is taken as significant.
RESULTS: 22.8% of the incident MHD cohort were found to have cystic changes, of which 78.1% constitute males and 21.8% females.
Cystic changes were observed in 46.6%in patients on MHD between 4-5yrs, 57.6% in patients on MHD between 5-6 yrs and to 75%in patients on
MHD greater than 6 yrs.
CONCLUSION: This study showed that Cystic kidney disease is an important complication of long term HD regardless of etiology of renal
failure, more seen in males and relates to duration of hemodialysis. Hence renal surveillance with USG or CT every 3yrs in all dialysis patients and
annually in patients with cystic changes.


Cyst, Hemodialysis, Azotemia

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Dunnill MS, Millard PR, Oliver D: Acquired cystic disease of the kidneys: A hazard of long-term intermittent maintenance hemodialysis. J Clin Pathol 1977; 30:868-77.

Truong LD, Choi YJ, Shen SS, et al: Renal cystic neoplasms and renal neoplasms associated with cystic renal diseases: Pathogenetic and molecular links. Adv Anat Pathol 2003; 10:135-1591.

Narasimhan N, Golper TA, Wolfson M, et al. Clinical characteristics and diagnostic considerations in acquired renal cystic disease. Kidney Int 1986; 30:748.

Ishikawa I. Acquired cystic disease: mechanisms and manifestations. Semin Nephrol 1991; 11:671.

Grantham JJ. Acquired cystic kidney disease. Kidney Int 1991; 40:143 -152.

Lien YH, Hunt KR, Siskind MS, Zukoski C. Association of cyclosporin A with acquired cystic kidney disease of the native kidneys in renal transplant recipients. Kidney Int 1993; 44:613. 52

Herrera GA. C-erb B-2 amplification in cystic renal disease. Kidney Int 1991; 40:509.

Konda R, Sato H, Hatafuku F, et al. Expression of hepatocyte growth factor and its receptor C-met in acquired renal cystic disease associated with renal cell carcinoma. J Urol 2004; 171:2166

Truong LD, Krishnan B, Cao JT, et al: Renal neoplasm in acquired cystic kidney disease. Am J Kidney Dis 1995; 26:1-12.

Levine E, Slusher SL, Grantham JJ, Wetzel LH. Natural history of acquired renal cystic disease in dialysis patients: a prospective longitudinal CT study. AJR Am J Roentgenol 1991; 156:501.

Rainio J, De Giorgio F, Carbone A. Death from renal cyst: spontaneous or traumatic rupture? Am J Forensic Med Pathol 2006; 27:193.


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