Acquired Cystic Kidney


Disease 

What is acquired cystic kidney 

disease (ACKD)? 

Many people with chronic kidney disease develop ACKD, 

a condition in which the 

kidneys develop fluid-filled sacs called 

renal (kidney) cysts. ACKD occurs in 

children and adults. The cysts are more 

likely to develop in people who are on 

hemodialysis or peritoneal dialysis. Kidney failure, not dialysis, causes the cysts. 

However, the risk of developing ACKD 

increases with the number of years a 

person is on dialysis. 

■	 About 20 percent of people starting 

dialysis treatments already have 

ACKD. 

■	 About 60 to 80 percent of people on 

dialysis for 4 years develop ACKD. 

■	 About 90 percent of people on dialysis for 8 years develop ACKD.1, 2 

1

Fick-Brosnahan GM. Polycystic and acquired 

cystic kidney disease. In: Greenberg A, ed. Primer 

on Kidney Diseases. 3rd ed. National Kidney 

Foundation. San Francisco: Academic Press; 2001: 

303–308. 

2

Grantham JJ, Nair V, Winklhofer F. Cystic diseases 

of the kidney. In: Brenner B, ed. Brenner & Rector’s 

The Kidney. 6th ed. Philadelphia: W.B. Saunders; 

2000: 1699–1730. 

In most cases, the cysts are harmless and 

require no treatment. Sometimes problems occur—including infection in the 

cyst, which may be associated with fever 

and back pain. Sometimes the cysts bleed 

and blood will appear in the urine. Blood 

in the urine should always be reported to 

a doctor. 

Although doctors debate the exact percentage, somewhere between 10 and 

20 percent of people with ACKD develop 

kidney tumors, which in some cases are 

cancerous.2 The rate of kidney cancer in 

people with ACKD is low, but it is higher 

than the rate in the general population. 

Cysts 

In ACKD, the kidneys develop fluid-filled sacs called cysts. 

U.S. Department of Health 


and Human Services
 

NATIONAL INSTITUTES OF HEALTH 

National Kidney and Urologic Diseases 

Information Clearinghouse
What are the kidneys and what do 

they do? 

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 hormones that 

regulate blood pressure, stimulate the production 

of red blood cells, and regulate the body’s use of 

calcium to keep the bones healthy. 

When the kidneys stop working, a person must 

receive a new kidney through transplantation or 

have regular blood-cleansing treatments called 

dialysis. 

Kidneys 

Bladder 

Ureters 

Kidney 

Ureter 

Urethra 

Bladder 

The kidneys filter wastes and extra fluid from the blood to produce urine. Urine flows from the kidneys to the bladder through 

the ureters. 

What causes ACKD? 

Dialysis filters out many, but not all, of the wastes 

that healthy kidneys remove. Researchers believe 

that an unidentified waste product not removed 

through dialysis causes cysts to form in the kidneys. Dialysis itself does not cause the cysts. 

How does ACKD differ from polycystic 

kidney disease (PKD)? 

ACKD differs from PKD in several ways. People 

with PKD often have a family history of PKD. 

They are born with the disease-causing gene. No 

disease-causing gene is associated with ACKD. 

PKD is associated with enlarged kidneys and cyst 

formation in other parts of the body. In ACKD, 

the kidneys are normal sized or smaller and cysts 

do not occur in other parts of the body. In PKD, 

the presence of cysts marks the onset of disease. 

People with ACKD already have chronic kidney 

disease when they develop cysts. 

What are the symptoms of ACKD? 

ACKD often has no symptoms. If a cyst becomes 

infected, a person may have back pain, fever, or 

even chills. If a cyst bleeds, a person will often 

notice blood in the urine. 

2 
 

How is ACKD diagnosed? 

A doctor may suspect ACKD based on a patient’s 

history and symptoms. To confirm the diagnosis, the doctor may order one or more imaging 

procedures: 

■	 Ultrasound. 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. 

■	 Computerized tomography (CT) scan. 

CT scans use a combination of x rays 

and computer technology to create threedimensional 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. 

■	 Magnetic resonance imaging (MRI). 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. 

Images of the kidneys may help the health care 

provider distinguish ACKD from PKD. 

How is ACKD treated? 

If ACKD 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. 

3 
Points to Remember 

■ 	Acquired cystic kidney disease (ACKD) is a 

condition in which the kidneys develop many 

fluid-filled sacs called cysts. 

■ 	ACKD is most common in people who have 

been on dialysis for several years. 

■ 	ACKD differs from polycystic kidney disease 

(PKD). People with PKD often have a family history of PKD. PKD is associated with 

enlarged kidneys and cyst formation in other 

parts of the body. In ACKD, the kidneys are 

normal sized or smaller and cysts do not form 

in other parts of the body. 

■	 Between 10 and 20 percent of people with 

ACKD develop kidney tumors, which in some 

cases are cancerous. 

■ 	ACKD often has no symptoms. 

■ 	If tumors are suspected, a person may need 

regular examinations to monitor the kidneys 

for cancer. 

■ 	In rare cases, surgery is used to stop cysts from 

bleeding and to remove tumors or suspected 

tumors. 

■ 	ACKD usually disappears after a person 

receives a transplanted kidney. 

Hope through Research 

In recent years, researchers have learned a great 

deal about kidney disease. The National Institute 

of Diabetes and Digestive and Kidney Diseases 

(NIDDK) sponsors several programs aimed at 

understanding kidney failure and finding treatment 

to stop its progression. The NIDDK’s Division of 

Kidney, Urologic, and Hematologic Diseases supports basic research into normal kidney function 

and the diseases that impair normal function at the 

cellular and molecular levels, including diabetes, 

high blood pressure, glomerulonephritis, and cystic kidney diseases. 

Participants in clinical trials can play a more active 

role in their own health care, gain access to new 

research treatments before they are widely available, and help others by contributing to medical 

research. For information about current studies, 

visit www.ClinicalTrials.gov. 

4 
For More Information 

American Association of Kidney Patients 

3505 East Frontage Road, Suite 315 

Tampa, FL 33607 

Phone: 1–800–749–2257 

Fax: 813–636–8122 

Email: info@aakp.org 

Internet: www.aakp.org 

American Kidney Fund 

6110 Executive Boulevard, Suite 1010 

Rockville, MD 20852 

Phone: 1–800–638–8299 

Fax: 301–881–0898 

Email: helpline@kidneyfund.org 

Internet: www.kidneyfund.org 

Life Options Rehabilitation Resource Center 

c/o Medical Education Institute, Inc. 

414 D’Onofrio Drive, Suite 200 

Madison, WI 53719 

Phone: 1–800–468–7777 

Email: lifeoptions@MEIresearch.org 

Internet: www.lifeoptions.org 

www.kidneyschool.org 

National Kidney Foundation 

30 East 33rd Street 

New York, NY 10016 

Phone: 1–800–622–9010 or 212–889–2210 

Fax: 212–689–9261 

Internet: www.kidney.org 

Acknowledgments 

Publications produced by the Clearinghouse are 

carefully reviewed by both NIDDK scientists and 

outside experts. This publication was reviewed by 

Catherine Kelleher, M.D., University of Colorado 

Health Sciences Center, Denver. 

About the Kidney Failure Series 

The NIDDK Kidney Failure Series includes 

booklets and fact sheets that can help you learn 

more about treatment methods for kidney failure, 

complications of dialysis, financial help for the 

treatment of kidney failure, and eating right on 

hemodialysis. For free single printed copies of 

this series, please contact the National Kidney and 

Urologic Diseases Information Clearinghouse. 

You may also find additional information about this topic by 

• searching the NIDDK Reference Collection at 

www.catalog.niddk.nih.gov/resources

• visiting MedlinePlus at www.medlineplus.gov

This publication may contain information about medications. 

When prepared, this publication included the most current 

information available. For updates or for questions about any 

medications, contact the U.S. Food and Drug Administration 

toll-free at 1–888–INFO–FDA (1–888–463–6332) or visit 

www.fda.gov. Consult your doctor for more information. 

5 
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Phone: 1–800–891–5390 

TTY: 1–866–569–1162 

Fax: 703–738–4929 

Email: nkudic@info.niddk.nih.gov 

Internet: www.kidney.niddk.nih.gov 

The National Kidney and Urologic Diseases 

Information Clearinghouse (NKUDIC) 

is a service of the National Institute of 

Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the 

National Institutes of Health of the U.S. 

Department of Health and Human Services. 

Established in 1987, the Clearinghouse 

provides information about diseases of the 

kidneys and urologic system to people with 

kidney and urologic disorders and to their 

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This publication is not copyrighted. The Clearinghouse encourages users of this fact sheet to duplicate 

and distribute as many copies as desired. 

This fact sheet is also available at 

www.kidney.niddk.nih.gov. 

U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES 

National Institutes of Health 

NIH Publication No. 09–6403 

May 2009