Acquired Cystic Kidney Disease – Symptoms, Diagnosis and Treatment
Acquired cystic kidney disease is a condition that occurs in people with chronic kidney disease. The kidneys develop cysts which are small sacs filled with fluid.
The kidneys are responsible for filtering wastes and any unnecessary liquids from the body. These wastes are then expelled from the body in the form of urine. Kidneys have several other functions beside filtration including hormone and electrolyte regulation.
Patients that are on either hemodialysis or renal dialysis are more prone to develop acquired cystic kidney disease. Dialysis is a procedure used to filter out the waste products and fluids that the kidneys no longer can.
Fast Facts about Acquired Cystic Kidney Disease
- Acquired cystic kidney disease (ACKD) occurs in people with chronic renal failure
- ACKD patients usually do not have any symptoms
- The cysts are caused from waste products building up in the kidneys from poor filtration
- There is no cure for AKCD, although a kidney transplant will eliminate the cysts. Rarely surgical procedures will be needed for excessively bleeding cysts or draining cysts
- Occasionally these cysts form tumors and a small percentage of them will be cancerous
- Polycystic kidney disease is a totally different disease from ACKD
Causes of Acquired Cystic Kidney Disease
As kidney function becomes severely impaired, wastes build up in the body. These wastes are removed by either hemodialysis or peritoneal dialysis. Dialysis can remove most of the wastes the body produces but not all of it. Wastes that are left behind are theorized to cause the cysts in the kidneys to form. It is believed that it is not the dialysis that causes the cysts to form but rather the kidney disease itself and the lack of total waste removal.
Polycystic kidney disease (PKD) is not related to acquired cystic kidney disease (ACKD). PKD has a specific genetic defect that causes the disease. There is no genetic abnormality associated with ACKD. Patients with polycystic kidney disease may develop ACKD while they are on dialysis; however, this is long after the polycystic kidney disease has been diagnosed. Patients with ACKD tend to have smaller than normal kidneys while patients with PKD have enlarged kidneys. Patients with PKD tend to form cysts in other body parts while ACKD patients only have cysts in the kidneys.
Risk Factors for Acquired Cystic Kidney Disease
Any patient that has chronic renal failure is at risk for developing acquired cystic kidney disease (ACKD). Since the cause of ACKD is the lack of filtration, the longer a person has chronic renal failure, the more likely they are to develop ACKD. About 90% of patients that require dialysis and therefore have minimal to no kidney function left develop ACKD.
Symptoms of Acquired Cystic Kidney Disease
There are actually no signs that the patient has acquired cystic kidney disease unless the cyst ruptures or becomes infected. If the cyst ruptures there may be pain in the back around the kidney area or blood in the urine. If a cyst becomes infected the patient may have back or abdominal pain and a fever. Patients should report any of these symptoms to their physician.
Diagnosing Acquired Cystic Kidney Disease
Since acquired cystic kidney disease (ACKD) usually has no symptoms, the physician will order testing based on other diagnosis such as ruling out polycystic kidney disease. If a patient has had chronic renal failure for a prolonged time or has been on dialysis for a prolonged period tests may be ordered. These might include ultrasound, CT scans or MRI.
Ultrasound is a painless test that involves the use of ultrasound waves. A cool conducting gel will be applied to the patient’s abdomen. An ultrasound technician will gently slide a transducer through the gel over the abdomen to visualize the kidneys. The sound waves bounce back off the organs and tissues in the abdomen and give a picture that the physician can than read.
Computerized tomography (CT) scan may also be ordered. CT scans are x-rays that give a three dimensional picture of the body with the help of a computer. The resulting images give the physician a picture of how many cysts are involved and where they are located. CT scans can make some patients claustrophobic. Patient’s lie on a narrow table and the body is inserted into a donut hole like opening. Since only the abdomen will need to be in the scanner, patients usually tolerate this CT scan fairly well.
Magnetic Resonance Imaging (MRI) is like a CT scan only very strong magnetic energy along with radio waves is used to form the picture. This machine is very loud, but the picture is very clear. Before a patient can have an MRI, they are thoroughly screened for any implanted metal devices. The very strong magnets in the machine can cause serious damage to patients and equipment. Any loose metal and implanted metal will be rapidly pulled to the magnet.
Treatment Options for Acquired Cystic Kidney Disease
Unless the cysts are causing problems no treatment is needed. If the patient with acquired cystic kidney disease (ACKD) develops an infection then antibiotics are prescribed. Cysts that become painful may need to be drained. Rarely will patients require surgical intervention. However, on occasion bleeding does become an issue. In these cases the cyst is surgically removed. It is impossible to remove all the cysts. Occasionally these cysts do become tumors. Less than 25% of patients with ACKD develop tumors. The majority of these will not be cancerous.
Prevention of Acquired Cystic Kidney Disease
There is no known way to prevent acquired cystic kidney disease. It is entirely a function of lack of kidney filtration. Interestingly, when a patient receives a kidney transplant the diseased kidneys are usually left in place. After the new kidney begins to function, the cysts on the diseased kidneys will shrink and disappear.
Coping with Acquired Cystic Kidney Disease
Aside from check-ups to monitor the progression of cysts, acquired cystic kidney disease (ACKD) should not affect your life much. Some people have more trouble than others with painful cysts and that of course does affect quality of life. Research is underway to help prevent kidney failure and thus eliminate ACKD. Hopefully, a cure will be found soon.