Acquired Renal Cystic Disease

Uremic Acquired Renal Cystic Disease

“…The size of the tumor is irrelevant, although if it is less than 3 cm in diameter, it may be safe to be left to fol low-up for 3-6 months. On the other hand, there have been reports of tumors of 1.2 cm, 2 cm and 3 cm in diameter that have undergone generalized metastasis [32]. It may therefore be advisable to remove any kidney harboring a renal cell carcinoma of more than 2 cm in diameter.…”

“…5) As already mentioned, acquired renal cystic disease itself is symptomless unless complicated with renal cell carcinoma, cyst rupture, ureteral obstruction due to ITmicroglobulin-induced protein stone formation, or cyst infection [32]. Even in patients with renal cell carcinoma, only 14% reveal symptoms.…”

“…1). As the history of dialysis increases, so too does the incidence of cystic transforma tion; 43.5% in patients with less than 3 years of hemodi alysis and 79.3% in those with more than 3 years [28], This climbs to 90% if hemodialysis has been performed for more than 10 years [32], with the grade of cystic change, as reflected by alteration in kidney size, rising also. In pa tients with end-stage kidneys who have never been dia lyzed, acquired cysts develop at a rate of 7-22% [13,30].…”

“…Cysts or cancer could arise simply through senescence [51] or via unidentified, chemically related environmental substances [42], It may in fact be that the same stimulation that leads to cyst formation in dialysis patients continues to act in time to eventually cause renal cell carcinoma [4,20]. Such renal carcinomas in dialysis patients tend to be multifocal and bilateral, suggesting that they are linked to the impairment of immunosurveillance [32].…”

“…Larger tumors are thus more likely to metastasize than smaller ones (p <0.001). At the time of these investigations, the death rate from renal cell carcinoma for dialysis patients was 35 of 362 (9.7%) [53], however, it should be kept in mind that there are extant, rapidly growing tumors in patients with extensive cystic changes [32].…”