Acquired renal cystic disease and adenocarcinoma following renal transplantation--a current urologic perspective.

Two patients treated with chronic dialysis and renal transplantation developed acute hemorrhage from a native kidney. Bilateral native nephrectomy demonstrated acquired cystic disease and adenocarcinoma in each of the four kidneys. The etiology of acquired cystic kidney disease (ACKD) is unclear and its incidence increases with the duration of dialysis. ACKD patients have a propensity to develop adenomas and adenocarcinomas. The increased incidence of renal neoplasms in ACKD patients warrants careful radiologic monitoring of native end-stage kidneys in selected patients.