Acquired cystic kidney disease in ESRD.

Acquired cystic kidney disease (ACKD) in patients undergoing dialysis has been associated with life-threatening complications. Potential malignant transformation of the cysts has prompted concern regarding the need to screen patients for ACKD. The assumed increased morbidity associated with malignant transformation has not been clearly documented in the literature and may require further long-term analysis to adequately assess. Many reports on ACKD refer to the risk for malignancy, but other complications associated with ACKD may also arise. The development of ACKD has been shown to increase with increasing time on dialysis. Patients on dialysis appear to have a longer life expectancy and, consequently, more will develop ACKD. Complications related to ACKD may increase, which bolster efforts to establish specific guidelines related to the screening and management of ACKD. Nephrology nurses should be aware of symptoms suggesting a complication related to ACKD and confer with the nephrologist regarding evaluation. This article will discuss implications and management related to an increasing incidence of ACKD.