Acquired cystic kidney disease in patients on maintenance hemodialysis, prevalence and associated factors: a cross-sectional study

Abstract

Introduction: Acquired Cystic Kidney Disease (ACKD) is a known complication in patients on maintenance hemodialysis, and it is associated with a high risk of malignant transformation. There is a paucity of data on ACKD in sub-Saharan Africa. Objectives: To determine the prevalence and factors associated with acquired cystic kidney disease in patients on maintenance hemodialysis.

Methods: patients on maintenance hemodialysis were screened for ACKD. Patients with hereditary cystic kidney disease were excluded. Renal ultrasounds were performed by two radiologists. Acquired Cystic Kidney Disease (ACKD) was defined as 3 or more bilateral renal cysts in a small or normal-sized kidney. Associated factors were determined using logistic regression. A p-value <0.05 was significant.

Results: a total of 158 participants were enrolled and 61.4% (97) were male. Their mean (SD) age was 45.8 (14.9) years. The median dialysis vintage was 33.5 [10.7-63.2] months. The mean (SD) length of the kidneys was 85.1 (17.5) mm on the left and 81.2 (17.1) mm on the right. The prevalence of ACKD was 31.6% (n=50). Septated cysts (4), calcification of the wall of the cysts (2), irregular thick calcified wall (1), septated cysts with calcification (1) and hemorrhagic cyst (1) cysts were also observed. Dialysis vintage > 36 months (OR 7.1, 95% CI: 3.3 - 15.5) and male sex (OR 2.6, 95% CI: 1.2-5.6) were independently associated with ACKD.

Conclusion: the prevalence of ACKD is high in a population of Cameroonians on maintenance. This result calls for the implementation of strategies to screen for the condition and its complications.