Acquired Cystic Kidney Diseases

Acquired cystic kidney disease happens when a person's kidneys develop fluid-filled sacs, called cysts, over time.

Acquired cystic kidney disease occurs in children and adults who have

• CHRONIC KIDNEY DISEASE (CKD)—a condition that develops over many years and may lead to end-stage kidney disease, or ESRD. The kidneys of people with CKD gradually lose their ability to filter wastes, extra salt, and fluid from the blood properly.
• END-STAGE KIDNEY DISEASE—total and permanent kidney failure that requires a kidney transplant or blood-filtering treatments called dialysis.

HOW COMMON IS ACQUIRED CYSTIC KIDNEY DISEASES?

Acquired cystic kidney disease becomes more common the longer a person has CKD.

• About 7 to 22 percent of people with CKD already have acquired cystic kidney disease before starting dialysis treatments.
• Almost 60 percent of people on dialysis for 2 to 4 years develop acquired cystic kidney disease.
• About 90 percent of people on dialysis for 8 years develop acquired cystic kidney disease.

COMPLICATIONS

People with acquired cystic kidney disease may develop the following complications:

• An infected cyst, which can cause fever and back pain.
• Blood in the urine, which can signal that a cyst in the kidney is bleeding.
• Tumors in the kidneys. People with acquired cystic kidney disease are more likely than people in the general population to have cancerous kidney tumors. However, the chance of cancer spreading is lower in people with acquired cystic kidney disease than that of other kidney cancers not associated with acquired cystic kidney disease, and the long-term outlook is better.

DIAGNOSIS:

A health care provider may diagnose a person with acquired cystic kidney disease based on

• Medical history
• Imaging tests

MEDICAL HISTORY:

Taking a medical history may help a health care provider diagnose acquired cystic kidney disease. A health care provider may suspect acquired cystic kidney disease if a person who has been on dialysis for several years develops symptoms such as fever, back pain, or blood in the urine.

IMAGING TESTS:

To confirm the diagnosis, the health care provider may order one or more imaging tests. A radiologist—a doctor who specializes in medical imaging—interprets the images from these tests, and the patient does not need anesthesia.

• Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. The images can show cysts in the kidneys as well as the kidneys' size and shape.
• Computerized tomography (CT) scans use a combination of x-rays and computer technology to create images. CT scans can show cysts and tumors in the kidneys.
• Magnetic resonance imaging (MRI) is a test that takes pictures of the body's internal organs and soft tissues without using x-rays. The technician will take a sequence of images from different angles to create a detailed picture of the kidneys.

Sometimes a health care provider may discover acquired cystic kidney disease during an imaging exam for another condition. Images of the kidneys may help the health care provider distinguish acquired cystic kidney disease from PKD

TREATMENT:

If acquired cystic kidney disease is not causing complications, a person does not need treatment. A health care provider will treat infections with antibiotics—medications that kill bacteria. If large cysts are causing pain, a health care provider may drain the cyst using a long needle inserted into the cyst through the skin.

When a surgeon transplants a new kidney into a patient's body to treat kidney failure, acquired cystic kidney disease in the damaged kidneys, which usually remain in place after a transplant, often disappears.

A surgeon may perform an operation to remove tumors or suspected tumors. In rare cases, a surgeon performs an operation to stop cysts from bleeding.

DIET:

A person may prevent or delay some health problems from chronic kidney disease (CKD) by eating the right foods and avoiding foods high in sodium, potassium, and phosphorus. Learning about calories, fats, proteins, and fluids is important for a person with advanced CKD. Protein foods such as meat and dairy products break down into waste products that healthy kidneys remove from the blood.