ACQUIRED RENAL CYSTIC-DISEASE IN CHILDREN AND YOUNG-ADULTS ON MAINTENANCE DIALYSIS

Acquired renal cystic disease (ARCD) is a well-known complication of e nd-stage renal disease (ESRD). We studied 24 patients, aged 8-27 years (mean 19.8 +/- 5.3 years), on chronic maintenance dialysis in our ser vice. The duration of dialysis ranged between 13 and 192 months (mean 77.8 +/- 44.3 months). High-resolution ultrasonography revealed ARCD i n 11 (45.8%) patients. No cysts were seen in 7 (29.1%) patients and so litary cysts in one or both kidneys were seen in 6 (25%) patients. Ren al malignancy was diagnosed in 2 patients. One, 15 years old, had rena l cell carcinoma after being on dialysis for 6 years. She did well aft er bilateral nephrectomy, left salpingo-oophorectomy, and regional lym phadenectomy. The second patient, 23 years old, had been on dialysis f or 16 years when she developed renal oncocytoma. She died of congestiv e cardiomyopathy 6 months later. We conclude that ARCD is common in ch ildren and young adults with ESRD. Neoplastic transformation, although rare, is a potential complication. Annual follow-up with ultrasonogra phy with selective use of computed tomography or magnetic resonance im aging is advised.