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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.


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.


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



No specific dietary intervention is required.



During a bleeding episode, bed rest is required.

Contributor Information and Disclosures

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.

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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
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
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