Acquired Cystic Disease
Acquired Cystic Disease
Updated: 10/06/2020
© Jun Wang, MD, PhD
General features
- Definition: Four or more cysts involving both kidneys
- No history of hereditary cystic renal disease
- History of chronic renal disease, especially hemodialysis or peritoneal dialysis
- High risk of renal cell carcinoma
Pathogenesis
- Probably due to uremia, obstruction by oxalate crystals, fibrosis, hyperplasia, as resulted in severe renal impairment
- Tubular hyperplasia resulted from compensatory renal hypertrophy through activation of oncogenes and release of growth factors
Clinical presentations
- Commonly asymptomatic
- Hemorrhagic cysts: Flank pain and gross hematuria
Pathological findings
- Small kidneys
- Small cysts, usually < 0.5 cm
- Normal tissue between cysts
Diagnosis
- Radiologic studies: Sonography, CT, MRI
Management
- Supportive
- Nephrectomy or embolization if severe bleeding
- Long-term monitoring for renal cell carcinoma: Sonographic or MRI
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