Developmental process of acquired renal cysts and neoplasms in patients receiving chronic hemodialysis: ultrasonographic, morphometric and histopathological studies.

The process of development of acquired cysts and neoplasms in the kidneys of patients receiving hemodialysis was investigated. An ultrasonographic study of 329 hemodialysis patients revealed that the size of the kidney decreased in the first 3 years of dialysis, then increased up to 8 years, and thereafter decreased again. Morphometric and histopathological studies were conducted on 31 kidneys removed from 17 patients. The total number of cysts and total volume of cysts increased over the period of 3 to 8 years, and renal size was positively correlated with total cyst volume during this period. The incidences of atypical hyperplastic cysts and microadenomas increased with prolongation of the dialysis period. Three cases of renal cell carcinoma were observed in the present series, of which two exhibited extensive cystic transformation with numerous neoplastic foci. These findings indicate a close relationship between the extent of acquired cysts, dialysis duration and risk of renal neoplasms.