Uremic acquired cystic disease of kidney.

Multiple cystic disease occurring in the diseased kidneys of patients with end-stage renal insufficiency is called uremic acquired cystic disease of the kidney. In male patients undergoing long-term hemodialysis the incidence of ACDK is markedly high. ACDK is known to be accompanied by tumor, bleeding, calculus, abscess, etc., and the complication of cancer of the kidney is a special problem. In patients undergoing hemodialysis, occurrence of ACDK, tumor, and kidney cancer are observed respectively at the rate of 47.1, 4.8, and 1.5 per cent. When hemodialysis patients show gross hematuria, flank pain, rapid decrease in hematocrit, and sustained fever, ACDK or its complications should be investigated. Since the risk accompanied by kidney cancer is high in spite of a lack of symptoms, regular screening by ultrasonic examination or CT scan is needed. Renal transplantation is also recommended because of the regression of ACDK after successful renal transplantation. In the future, it appears that ACDK should be considered one disease entity and added to the categories of renal cystic diseases. In addition, ACDK can be studied as a model for clarification of the mechanism of cyst and tumor occurrence.