Radiology of the kidneys in patients under maintenance hemodialysis

The kidneys of patients with chronic renal failure undergoing maintenance h emodialysis may show different variances or complications. Most common are secondarily acquired renal cysts, which may be found in as many as 92% of p atients after 8 years of hemodialysis. Single (in 12.5% of patients) or mul tiple (8.3%) cysts with bleeding are common; additionally, hematuria or rup tured cysts may be found. Bleeding into cysts is more common in patients wi th autosomal dominant polycystic kidney disease. Due to the decreasing urin ary production development of kidney stones is very uncommon, but calcifica tions in or around cysts can be found in 71% of patients. Kidney tumors occ ur 41 times more often in patients with chronic renal failure than in patie nts without kidney disease. We detected tumors in 4.2% of our patients on l ong-term dialysis. Diagnostic differentiation of the relatively slow growin g and fairly tate metastasizing malignant tumors from adenomas is not possi ble. Nevertheless, we screen our patients every 3-4 years. Computed tomogra phy is superior to ultrasonography for this purpose, because ultrasonograph y lacks the necessary sensitivity in this group of patients.