Acquired renal cystic disease in children and young adults on maintenance dialysis.
Acquired renal cystic disease (ARCD) is a well-known complication of end-stage renal disease (ESRD). We studied 24 patients, aged 8-27 years (mean 19.8 +/- 5.3 years), on chronic maintenance dialysis in our service. The duration of dialysis ranged between 13 and 192 months (mean 77.8 +/- 44.3 months). High-resolution ultrasonography revealed ARCD in 11 (45.8%) patients. No cysts were seen in 7 (29.1%) patients and solitary cysts in one or both kidneys were seen in 6 (25%) patients. Renal malignancy was diagnosed in 2 patients. One, 15 years old, had renal cell carcinoma after being on dialysis for 6 years. She did well after bilateral nephrectomy, left salpingo-oophorectomy, and regional lymphadenectomy. The second patient, 23 years old, had been on dialysis for 16 years when she developed renal oncocytoma. She died of congestive cardiomyopathy 6 months later. We conclude that ARCD is common in children and young adults with ESRD. Neoplastic transformation, although rare, is a potential complication. Annual follow-up with ultrasonography with selective use of computed tomography or magnetic resonance imaging is advised.
Mattoo
T K
TK
Division of Pediatric Nephrology, Albert Einstein College of Medicine, Rose F. Kennedy Center, Bronx, NY 10461, USA.
Greifer
I
I
Geva
P
P
Spitzer
A
A
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D052177:Kidney Diseases, Cystic / Q000175:diagnosis*; D007676:Kidney Failure, Chronic / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D006435:Renal Dialysis; D014057:Tomography, X-Ray Computed