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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