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Nephrol Dial Transplant (1992) 7: 613-617
© 1992 European Renal Association-European Dialysis and Transplant Association

research-article

Effect of treatment mode on the natural history of acquired cystic disease of the kidney in patients on renal replacement therapy

D. A. S. Jenkins1,, R. M. Temple1, R. J. Winney1, P. L. Allan2, A. Notgi3 and S. R. Wild4

1Medical Renal Unit, Western General Hospital Edinburgh, UK 2Radiology Department, Edinburgh Royal Infirmary, Western General Hospital Edinburgh, UK 3Nuffield Transplant Unit, Western General Hospital Edinburgh, UK 4Radiology Department, Western General Hospital Edinburgh, UK

Correspondence and offprint requests to: Correspondence and offprint requests to: Dr D. A. S. Jenkins, Medical Renal Unit, Royal Infirmary of Edinburgh, Edinburgh EH3 9YW, UK

The natural history of acquired cystic disease of the kidney has been investigated in a longterm follow-up study of patients on renal replacement therapy. A cohort of 145 end-stage renal failure patients was initially investigated with ultrasonography to determine the degree of cystic change. Seventy-three patients were available for follow up a minimum of 3 years later. The grade of cystic disease progressed in dialysis patients and progression was more marked in haemodialysis patients than patients maintained on CAPD. Patients with functioning renal transplants did not show progression of cystic change and in two patients regression was seen. Nine patients maintained on chronic dialysis at the time of initial ultrasound subsequently received renal grafts, and three of these patients had evidence of regression of cystic change on follow-up scanning. After 3 years follow-up a single haemodialysis patient had evidence of a solid lesion in a cystic kidney and this has not progressed during a further 12 months of follow-up. Acquired cystic disease of the kidney is a progressive disease in chronic dialysis patients. However, over a follow-up period of 3 years, patients with functioning renal grafts do not show similar progression. The incidence of solid renal tumours has been shown to be low.

Keywords: acquired cystic disease; renal ultrasound; chronic dialysis; renal transplantation


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