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There are many types of cystic diseases of the kidney, but a specific form often occurs in end-stage kidney disease (ESKD) patients. Acquired cystic kidney disease (ACKD) is defined by the presence of four or more renal cysts for both kidneys and the absence of any hereditary renal cystic disease. These cysts are associated with potential complications, including significant bleeding and malignant neoplasms.
ACKD is more commonly observed in men and those of African descent. Acquired renal cysts are found in fewer than 10% of predialysis patients with long-standing azotemia (serum creatinine > 2.5 mg/dL). However, the incidence increases to 10% to 20% after 1 to 3 years of dialysis and 90% or greater in those dialyzed for more than 8 to 10 years. These cysts have been reported in patients on either peritoneal dialysis or hemodialysis. Azotemia is the only consistent factor in the development of ACKD.
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