Acquired cystic kidney disease: Description, Causes and Risk Factors:
Renal cystic disease is a term that represents a wide spectrum of diseases that may be hereditary, developmental, or acquired; these diseases share the feature of renal cysts. These cysts can occur in the cortex, the corticomedullary junction, and/or the medulla, depending on the underlying disease process. Acquired cysts can be simple or part of acquired cystic kidney disease (ACKD), also called acquired renal cystic disease (ARCD).
The kidneys are two bean-shaped organs, each about the size of a fist. They are located on either side of the spine, just below the rib cage. The kidneys filter wastes and extra fluid from the blood to produce urine. They also release hormo
nes that regulate blood pressure, stimulate the production of red blood cells, and regulate the body's use of calcium to keep the bones healthy.
At present, researchers are not clear about what causes ACKD, but there some causing factors may be involved in exerting ACKD. During dialysis, there might be some waste products not removed like polyamine, depositing in body and causing cysts to form in the kidneys. With carcinogenicity, dimethyl nitrosamine (DMN) and disinfectants in the water used in dialysis might stimulate cysts to grow in kidneys. The end stage kidney failure will open many factors causing cysts suc
h as the lack of blood and oxygen, blocking in kidney tubules, secreting substances provoking cysts and so on. Instead of merely renal pathological changes, ACKD can be considered as a secondary disease after renal functions failing.
• Cigarette smoking doubles the risk.
• Obesity: increasing body weight linear relationship with increasing risk.
• Occupational exposure: cadmium, asbestos, trichloroethylene: 1?2x risk
• Genetic factors: tuberous sclerosis, VHL disease.
• Hypertension, prior radiation, sickle cell disease.
• Men and blacks are at much higher risk.
• Serum hepatocyte growth factor (HGF) increases as renal failure progresses, higher in patients on dialysis. (HGF mRNA and HGF protein, along with c?met protein upregulated in patients with RCC.)
• Proto?oncogen C?Jun is activated in atypical hyperplastic proliferative cells in ACKD and plays a role in RCC carcinogenesis.
• Anti?apoptotic Bcl?2 over?expression may also have a role in tumor development.
• High proliferative activity of cyst epithelia in ACKD suggests, that these cysts may be RCC precursors.
• Abdominal pain or tenderness.
• Blood in the urine.
• Excessive urination at night.
• Flank pain on one or both sides.
Additional symptoms that may be associated with this disease include the following:
• High blood pressure
• Joint pain.
• Nail abnormalities.
• Painful menstruation.
A doctor may suspect acquired cystic kidney disease based on a patient's history and symptoms. To confirm the diagnosis, the doctor may order one or more imaging procedures:
• CT scan: CT scans use a combination of x rays and computer technology to create three-dimensional images. Sometimes a contrast dye is injected into the patient to better see the structure of the kidneys. CT scans require the patient to lie on a table that slides through a donut-shaped scanning machine. CT scans can help identify cysts and tumors in the kidneys.
: In an ultrasound, or sonogram, a technician glides a device, called a transducer, over the abdomen. The transducer sends harmless sound waves into the body and catches them as they bounce off the internal organs to create a picture on a monitor. Abdominal ultrasounds are used to evaluate the size and shape of the kidneys.
• MRI Scan: MRI machines use radio waves and magnets to produce detailed pictures of internal organs and tissues. No exposure to radiation occurs. With most MRI machines, the patient lies on a table that slides into a tunnel that may be open-ended or closed at one end. Some newer machines are designed to allow the patient to lie in a more open space. Like CT scans, MRIs can help identify cysts and tumors.
If acquired cystic kidney disease is not causing pain or discomfort, no treatment is required. Infections are treated with a course of antibiotics. If large cysts are causing pain, they may be drained using a long needle inserted through the skin.
If tumors are suspected, a person may need regular examinations to monitor the kidneys for cancer. Some doctors recommend all patients be screened for kidney cancer after 3 years of dialysis. In rare cases, surgery is used to stop cysts from bleeding and to remove tumors or suspected tumors.
In transplantation, the diseased kidneys are left in place unless they are causing infection or high blood pressure. ACKD usually disappears, even in the diseased kidneys, after a person receives a transplanted kidney.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.