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Kidney Week

Abstract: FR-PO1158

Acquired Cystic Kidney Disease in Children and Young Adults Undergoing Dialysis

Session Information

  • Pediatric Nephrology - I
    October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1600 Pediatric Nephrology

Authors

  • Cho, Myung hyun, Seoul National university Children''s hospital, Seoul, Korea (the Republic of)
  • Kim, Ji hyun, Seoul National university Children''s hospital, Seoul, Korea (the Republic of)
  • Kang, Hee Gyung, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
  • Cheong, Hae Il, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
  • Ha, IL-Soo, Seoul National University Children's Hospital, Seoul, Korea (the Republic of)
Background

Acquired cystic kidney disease (ACKD) describes bilateral cystic degeneration of the kidneys in patients who do not have cystic diseases. It is known as a common complication of end-stage renal disease (ESRD) in adults, however pediatric studies were scarce. We aimed to determine the prevalence, time of occurrence, and complications of ACKD in children and young adults undergoing dialysis.

Methods

We retrospectively reviewed the medical records of ESRD patients who were followed at Seoul National University Children’s Hospital between January 2015 and April 2018. We enrolled a patient if he/she had taken kidney imaging of ultrasonography or computer tomography after initiating maintenance dialysis. Patients with hereditary cystic disease were excluded.

Results

A total of 64 patients (male : female = 40 : 24) were enrolled. Maintenance renal replacement therapy was required at their mean age of 9.3 ± 6.0 years old. Causes of ESRD were non-cystic congenital anomalies of the kidney and the urinary tract (CAKUT) in 14 (21.9%), non CAKUT (glomerulonephritis in 34, nephrotoxin induced nephropathy in 4, hyperoxaluria in 2, and so on) in 44 (68.8%), and unknown in 6 (9.4%). Forty seven (73.4%) patients were on peritoneal dialysis, 12 (18.8%) on hemodialysis, and 5 (7.8%) on both. ACKD was found in 32 (50.0%). ACKD was detected 3.0 ± 2.5 years after the start of dialysis. In non CAKUT, the prevalence of ACKD increased with duration of dialysis, however it was not significant in non-cystic CAKUT (Fig. 1). Four (non CAKUT in 3 and unknown etiology in 1) had serious complications of ACKD; two had renal cell carcinomas, and 2 experienced massive hemorrhage. Complications occurred 3.9 to 12.2 years after the start of dialysis.

Conclusion

ACKD complicates ESRD of children and young adults as well. Since ACKD may accompany serious complications such as malignancy and hemorrhage, routine surveillance is necessary in high risk patients on maintenance dialysis.