Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Acquired Cystic Kidney Disease Treatment & Management

  • Author: Dwarakanathan Ranganathan, MD, DM, FRCP, FRACP; Chief Editor: Vecihi Batuman, MD, FACP, FASN  more...
 
Updated: Apr 28, 2015
 

Medical Care

Bleeding episodes (mild) with flank pain are treated with analgesics (eg, morphine, codeine, acetaminophen). Avoid aspirin and meperidine. Avoid heparin during hemodialysis.

Next

Surgical Care

See the list below:

  • Severe bleeding episodes are treated by embolization or nephrectomy.
  • If carcinoma is suspected (from CT scan findings), then consider nephrectomy (cysts >3 cm in diameter and cysts < 3 cm but with complications).
  • Prophylactic contralateral nephrectomy is controversial; bilateral nephrectomy may be considered in those patients likely to receive kidney transplantation.
Previous
Next

Consultations

If carcinoma is suspected in acquired renal cystic disease, consult a urologist.

Previous
Next

Diet

No specific dietary intervention is required.

Previous
Next

Activity

During a bleeding episode, bed rest is required.

Previous
 
 
Contributor Information and Disclosures
Author

Dwarakanathan Ranganathan, MD, DM, FRCP, FRACP Eminent Specialist, Head of Home, Independent Dialysis and Transition Services, Royal Brisbane and Women's Hospital, Australia

Dwarakanathan Ranganathan, MD, DM, FRCP, FRACP is a member of the following medical societies: American Society of Nephrology, International Society for Peritoneal Dialysis, International Society of Nephrology, Australia and New Zealand Society of Nephrology, Indian Society of Nephrology

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

George R Aronoff, MD Director, Professor, Departments of Internal Medicine and Pharmacology, Section of Nephrology, Kidney Disease Program, University of Louisville School of Medicine

George R Aronoff, MD is a member of the following medical societies: American Federation for Medical Research, American Society of Nephrology, Kentucky Medical Association, National Kidney Foundation

Disclosure: Nothing to disclose.

Chief Editor

Vecihi Batuman, MD, FACP, FASN Huberwald Professor of Medicine, Section of Nephrology-Hypertension, Tulane University School of Medicine; Chief, Renal Section, Southeast Louisiana Veterans Health Care System

Vecihi Batuman, MD, FACP, FASN is a member of the following medical societies: American College of Physicians, American Society of Hypertension, American Society of Nephrology, International Society of Nephrology

Disclosure: Nothing to disclose.

Additional Contributors

James W Lohr, MD Professor, Department of Internal Medicine, Division of Nephrology, Fellowship Program Director, University of Buffalo State University of New York School of Medicine and Biomedical Sciences

James W Lohr, MD is a member of the following medical societies: American College of Physicians, American Heart Association, American Society of Nephrology, Central Society for Clinical and Translational Research

Disclosure: Partner received salary from Alexion for employment.

References
  1. Kuroda N, Ohe C, Mikami S, Hes O, Michal M, Brunelli M, et al. Review of acquired cystic disease-associated renal cell carcinoma with focus on pathobiological aspects. Histol Histopathol. 2011 Sep. 26(9):1215-8. [Medline].

  2. Srigley JR, Delahunt B, Eble JN, Egevad L, Epstein JI, Grignon D, et al. The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia. Am J Surg Pathol. 2013 Oct. 37(10):1469-89. [Medline].

  3. Paudice N, Zanazzi M, Agostini S, Bertelli E, Caroti L, Carta P, et al. Contrast-enhanced ultrasound assessment of complex cystic lesions in renal transplant recipients with acquired cystic kidney disease: preliminary experience. Transplant Proc. 2012 Sep. 44(7):1928-9. [Medline].

  4. Rule AD, Sasiwimonphan K, Lieske JC, Keddis MT, Torres VE, Vrtiska TJ. Characteristics of renal cystic and solid lesions based on contrast-enhanced computed tomography of potential kidney donors. Am J Kidney Dis. 2012 May. 59(5):611-8. [Medline]. [Full Text].

  5. Takase Y, Kodama K, Motoi I, Saito K. Cyst Infection in Unilateral Renal Cystic Disease and the Role of Diffusion-weighted Magnetic Resonance Imaging. Urology. 2012 Nov. 80(5):e61-2. [Medline].

  6. Mühlfeld AS, Lange C, Kroll G, Floege J, Krombach GA, Kuhl C, et al. Pilot study of non-contrast-enhanced MRI vs. ultrasound in renal transplant recipients with acquired cystic kidney disease: a prospective intra-individual comparison. Clin Transplant. 2013 Nov-Dec. 27(6):E694-701. [Medline].

  7. Scandling JD. Acquired cystic kidney disease and renal cell cancer after transplantation: time to rethink screening?. Clin J Am Soc Nephrol. 2007 Jul. 2(4):621-2. [Medline].

  8. Schwarz A, Vatandaslar S, Merkel S, et al. Renal cell carcinoma in transplant recipients with acquired cystic kidney disease. Clin J Am Soc Nephrol. 2007 Jul. 2(4):750-6. [Medline].

  9. Acquired cystic kidney disease in children undergoing continuous ambulatory peritoneal dialysis. Kyushu Pediatric Nephrology Study Group. Am J Kidney Dis. 1999 Aug. 34(2):242-6. [Medline].

  10. Cohen EP, Elliott WC Jr. The role of ischemia in acquired cystic kidney disease. Am J Kidney Dis. 1990 Jan. 15(1):55-60. [Medline].

  11. Dunnill MS, Millard PR, Oliver D. Acquired cystic disease of the kidneys: a hazard of long-term intermittent maintenance haemodialysis. J Clin Pathol. 1977 Sep. 30(9):868-77. [Medline].

  12. Dwarakanathan S. Acquired renal cystic disease. Nephrology. 2003. 8:A62-A63.

  13. Fleming S, O'Donnell M. Surgical pathology of renal epithelial neoplasms: recent advances and current status. Histopathology. 2000 Mar. 36(3):195-202. [Medline].

  14. Grantham JJ. Acquired cystic kidney disease. Kidney Int. 1991 Jul. 40(1):143-52. [Medline].

  15. Gulanikar AC, Daily PP, Kilambi NK, et al. Prospective pretransplant ultrasound screening in 206 patients for acquired renal cysts and renal cell carcinoma. Transplantation. 1998 Dec 27. 66(12):1669-72. [Medline].

  16. Hayakawa M, Nakajima F, Tsuji A, et al. Cytokine levels in cystic renal masses associated with renal cell carcinoma. J Urol. 1998 May. 159(5):1459-64. [Medline].

  17. Ishikawa I. Hemorrhage versus cancer in acquired cystic disease. Semin Dial. Jan-Feb 2000. 13(1):56.

  18. Ishikawa I. Hemorrhage versus cancer in acquired cystic disease. Semin Dial. 2000 Jan-Feb. 13(1):56. [Medline].

  19. Levine E. Acquired cystic kidney disease. Radiol Clin North Am. 1996 Sep. 34(5):947-64. [Medline].

  20. Levine E, Slusher SL, Grantham JJ, et al. Natural history of acquired renal cystic disease in dialysis patients: a prospective longitudinal CT study. AJR Am J Roentgenol. 1991 Mar. 156(3):501-6. [Medline].

  21. Liu JS, Ishikawa I, Horiguchi T. Incidence of acquired renal cysts in biopsy specimens. Nephron. 2000 Feb. 84(2):142-7. [Medline].

  22. Moskowitz DW, Bonar SL, Liu W, et al. Epidermal growth factor precursor is present in a variety of human renal cyst fluids. J Urol. 1995 Mar. 153(3 Pt 1):578-83. [Medline].

  23. Nahm AM, Ritz E. Acquired renal cysts. Nephrol Dial Transplant. 2001 Jul. 16(7):1506-8. [Medline].

  24. Rubenstein I, Zanier J, Moraes E, et al. Renal cell carcinoma in patients with acquired renal cystic disease. Br J Urol. 1997. 80:118-9.

  25. Stewart JH, Buccianti G, Agodoa L, et al. Cancers of the kidney and urinary tract in patients on dialysis for end-stage renal disease: analysis of data from the United States, Europe, and Australia and New Zealand. J Am Soc Nephrol. 2003 Jan. 14(1):197-207. [Medline].

  26. Takebayashi S, Hidai H, Chiba T, et al. Using helical CT to evaluate renal cell carcinoma in patients undergoing hemodialysis: value of early enhanced images. AJR Am J Roentgenol. 1999 Feb. 172(2):429-33. [Medline].

  27. Todd TD, Dhurandhar B, Mody D, et al. Fine-needle aspiration of cystic lesions of the kidney. Morphologic spectrum and diagnostic problems in 41 cases. Am J Clin Pathol. 1999 Mar. 111(3):317-28. [Medline].

  28. Truong LD, Krishnan B, Cao JT, et al. Renal neoplasm in acquired cystic kidney disease. Am J Kidney Dis. 1995 Jul. 26(1):1-12. [Medline].

  29. Vaseemuddin M, Kraus MA. Quiz page. Acquired kidney disease (ACKD) with associated bilateral renal cell carcinoma. Am J Kidney Dis. 2005 Oct. 46(4):A48, e47-9. [Medline].

Previous
Next
 
Acquired cystic kidney disease. Patient with end-stage renal disease (ESRD) on maintenance hemodialysis presented with macrohematuria. Ultrasonogram showing numerous cysts in the right kidney and previous cysts in the left kidney.
Acquired cystic kidney disease. A 39-year-old man on dialysis for longer than 10 years with acquired renal cystic disease (ARCD). CT scan showed a mass in the lower pole of the right kidney. Fine-needle aspiration cytology (FNAC) of the lesion showed renal cell carcinoma. The patient underwent nephrectomy.
Acquired cystic kidney disease. A 66-year-old man with acquired renal cystic disease (ARCD) had a mass in the lower pole of the right kidney. CT-guided biopsy proved the mass to be renal cell carcinoma. This patient also had type II dissection of the aorta.
Table. Comparison of Findings in ARCD Versus ADPKD
Findings ARCD ADPKD
Kidney sizeUsually not increased; may be decreased because of the advanced renal diseaseIncreased
Location of cystsCortex and medullaCortex and medulla
Corticomedullary differentiation*PossibleNot possible
Normal parenchyma between cysts*YesNo
Extrarenal cysts (eg, liver, pancreas)NoYes
Positive family historyNoYes
*On ultrasonography
Previous
Next
 
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.