Acquired Cystic Kidney Disease: A Hidden Complication in Children on Chronic Hemodialysis

Abstract

Objective To determine the frequency of acquired cystic kidney disease (ACKD) in children on chronic hemodialysis. Material and methods In this single-center cross-sectional study, 150 children were included who were on chronic hemodialysis for six months. Ultrasound was done to see the renal cysts. Cystic changes that could not fulfill the criteria for ACKD were also noted and analyzed. Results The mean age was 14.5 ± 3.5 years, of these 63 (42%) were males. Acquired cysts were detected in 53 (35%) of the patient and 18 patients (12%) had solitary cysts. The distribution of these entities was similar across all age groups. The underlying etiologies in the descending order were unknown 64 (43%), stone disease 31 (21%), each of the congenital anomalies of the kidney and urinary tract, and glomerulonephritis 23 (15%), and others nine (6%). A higher frequency of ACKD was detected in the children on renal replacement therapy for more than two years (33 out of 53 children, 63% with a p-value of 0.004). Conclusion The ACKD was found in one-third of our hemodialysis children and its frequency increases with the duration of hemodialysis. This percentage may not reflect the true prevalence as there is a lack of consensus on the definition of ACKD. Periodic assessment of chronic kidney disease patients for the development of ACKD especially on chronic hemodialysis is required to reduce the morbidity.

Transformación poliquística de riñón trasplantado

“…Debemos saber atender y detectar a los pacientes con injertos renales añosos, y seguir protocolos para poder diagnosticar clínicamente patologías tanto degenerativas, estructurales y tumorales que pueden afectar a un injerto con tan larga vida, como en el caso del paciente, además de poder referir oportunamente a estudio genético a los donadores monorrenos. 11,12 Debemos destacar de manera importante el ampliar nuestra visión para integrar en nuestros centros protocolos de trasplante que incluyan donadores, principalmente fallecidos con características especiales, como los que lleguen a presentar enfermedad poliquística renal y poder asignar dichos órganos a receptores con menor esperanza de vida, en quienes se ha demostrado buena función del injerto a mediano plazo.…”