Kidney is one of the vital organs of our body, which filters the blood. Kidney disease resulting in malfunction of the kidney may cause electrolyte abnormalities or water retention. Severe kidney disease may result in lethal complications like renal failure or end stage renal disease. In this article, we will discuss about one such pathological condition of the kidney known as an Acquired Cystic Kidney Disease (ACKD). Acquire cystic kidney disease causes accumulation of fluid in the cyst within kidney. The disease may rarely involve both the kidneys. Cystic lesion of the kidney causes various complications, which will be discussed in this article. In this article, we will also discuss causes, symptoms, and treatments of Acquired Cystic Kidney Disease (ACKD).
How Is Acquired Cystic Kidney Disease (ACKD) Defined?
- Acquired cystic kidney disease is a hereditary disease.
- Acute Cystic Kidney Disease can occur in both children as well as adults.
- Acquired cystic kidney disease is more common in male and older population.
- The disease is observed in unhealthy kidney than normal kidney.
- The cyst is known as acquired renal cyst.
- The cyst is always formed in diseased kidney and cyst slowly increases in size as volume of fluid secretion increases.
- People on hemodialysis or peritoneal dialysis are more prone to develop Acute Cystic Kidney Disease.1
- Acquired Cystic Kidney Disease is a benign disease and may not require any treatment if growth is slow or stagnant
- The infection of the cyst should be promptly treated.
- In rare cases large sized cyst may bleed and need urgent emergency treatment.
Causes of Acquired Cystic Kidney Disease (ACKD)
Spilling of Metabolites-
- Dialysis procedure is to filter out waste products from the body when the kidney is not functioning appropriately.
- Dialysis tends to clear out most of the waste products but it is not able to remove all of the waste products, which normal functioning kidneys can remove.
- Researchers are of the opinion that some unidentified waste, which cannot be removed by dialysis, results in the formation of cysts in the kidneys, although dialysis itself does not cause the cysts to form.
Some Facts about Acquired Cystic Kidney Disease (ACKD)
- Acquired Cystic Kidney Disease (ACKD) is a pathological condition where cysts are formed in the kidneys.
- People who have been on dialysis chronically and for many years are prone to develop Acquired Cystic Kidney Disease.
- Almost 20% of individuals with Acquired Cystic Kidney Disease go on to develop renal tumors, which in some instances can be cancerous.
- Acquired Cystic Kidney Disease generally has no symptoms.
- In case kidney tumors are suspected, then the individual needs to have regular examinations of the kidneys to rule out cancer.
- In very rare instances, surgery may be done to prevent these cysts from bleeding and also to remove tumors.
What Is The Difference Between Acquired Cystic Kidney Disease (ACKD) and Polycystic Kidney Disease?
Acquired Cystic Kidney Disease (ACKD) is different from Polycystic Kidney Disease.
Acquired Cystic Kidney Disease (ACKD)-
- Acquired Cystic Kidney Disease (ACKD) is not caused by genetic mutation.
- The size of the kidney is rarely larger than normal size.
- Acquired Cystic Kidney Disease or ACKD is observed mostly in one kidney.
- Acquired Cystic Kidney Disease or ACKD is seen in children and adults.
- Chronic renal disease or end stage renal disease precedes the Acquired Cystic Kidney Disease or ACKD.
- Patient is treated with hemodialysis or peritoneal dialysis for several years preceding the diagnosis of Acquired Cystic Kidney Disease or ACKD.
- Literature suggests 60 to 80 percent of the patients who are on dialysis for more than 4 years suffer with Acquired Cystic Kidney Disease or ACKD.
Polycystic Kidney Disease-
- Family history of polycystic kidney disease
- Usually born with genes that cause Polycystic Kidney Disease
- Size of the kidney is larger than normal in Polycystic Kidney Disease.
- Polycystic Kidney Disease results rapidly in end stage renal disease.
Symptoms of Acquired Cystic Kidney Disease (ACKD)
Non Infected Acquired Cystic Kidney Disease (ACKD) -
- Pain in flank
Infected Acquired Cystic Kidney Disease (ACKD)
- Fever and chills
- Joint pain and body ache
- Flank or lower back pain
Symptoms of Complicated and Large ACKD2
- High blood pressure (hypertension)
- Palpable mass (large cyst)
- Obstruction of urinary flow in kidney (large cyst)
- Hemorrhage within cyst
- Rupture of cyst
Diagnosis Of Acquired Cystic Kidney Disease (ACKD)
Further investigation is advised once patient complaints of flank pain and hematuria.
Imaging test assist in differentiating acquired or polycystic kidney disease.
- Ultrasound Study3-
- Evaluates size and shape of the kidney
- Evaluate cystic swelling over surface of the kidney.
- Computerized tomography (CT) scan-
- The CT scan study is performed following intravenous dye injection, which helps to visualize kidney.
- CT scan gives 3 dimensional view of internal and external kidney tissue.
- Magnetic Resonance Imaging (MRI)3-
- Radiation exposure is avoided.
- MRIs can help to identify cysts and tumors.
Treatment for Acquired Cystic Kidney Disease (ACKD)
- Acquired Cystic Kidney Disease is usually considered a harmless condition and asymptomatic disease is often not treated.
- Treatment of infected cyst includes following medications-
- Non-steroidal anti-inflammatory medications (NSAIDs)
- Large cyst is often drained under guidance of ultrasound.
1. Acquired cystic kidney disease in children undergoing long-term dialysis.
Leichter HE1, Dietrich R, Salusky IB, Foley J, Cohen AH, Kangarloo H, Fine RN.
Pediatr Nephrol. 1988 Jan;2(1):8-11.
2. Complications of sporadic, hereditary, and acquired renal cysts: cross-sectional imaging findings.
Tonolini M1, Rigiroli F2, Villa F2, Bianco R2.
Curr Probl Diagn Radiol. 2014 Mar-Apr;43(2):80-90.
3. Acquired cystic kidney disease.
Levine E., Radiol Clin North Am. 1996 Sep;34(5):947-64.