Levine E
Department of Radiology, University of Kansas Medical Center, Kansas City, USA.
Radiol Clin North Am. 1996 Sep;34(5):947-64.
ACKD is characterized by the development of many fluid-filled renal cysts and sometimes neoplasms in the kidneys of individuals with chronic renal failure but without a history of hereditary cystic disease. The condition is seen mainly in dialysis patients, but often begins in patients with ESRD before dialysis is started. Most patients with ACKD are asymptomatic, but the disorder may be associated with such serious complications as retroperitoneal hemorrhage and metastatic renal cell carcinoma. The diagnosis of ACKD and its complications is best achieved by CT scanning, although US and MR imaging may be useful in evaluation, particularly in patients not treated with dialysis. Cyst hemorrhage is common in ACKD and may cause flank pain and hematuria. Hemorrhagic cysts may be recognized by their CT scan, sonographic, or MR imaging features. Hemorrhagic cysts may rupture into the perinephric space causing large perinephric hematomas. These can usually be treated-conservatively. Patients with ACKD, particularly those treated with dialysis, have an increased risk of renal cell carcinoma. Renal cell carcinoma may also develop in the native kidneys of renal transplant recipients with good graft function many years after transplantation. Annual imaging of the native kidneys of all dialysis patients or of transplant recipients for the development of carcinoma is not justified, however, because it has not been shown to have a significant effect on patient outcome. Screening may, however, be useful in selected dialysis patients with good general medical condition and who have known risk factors for renal cell carcinoma including prolonged dialysis, large kidneys, ACKD, and male gender. Screening of the native kidneys of transplant recipients may be performed when they are referred for US evaluation of the renal allograft.
获得性肾囊肿病（ACKD）的特征是，在患有慢性肾衰竭但无遗传性囊性疾病病史的个体的肾脏中出现许多充满液体的肾囊肿，有时还会出现肿瘤。这种情况主要见于透析患者，但通常在开始透析之前就已在终末期肾病（ESRD）患者中出现。大多数ACKD患者没有症状，但该疾病可能与诸如腹膜后出血和转移性肾细胞癌等严重并发症相关。尽管超声（US）和磁共振成像（MR）在评估中可能有用，特别是对于未接受透析治疗的患者，但通过CT扫描最能实现对ACKD及其并发症的诊断。囊肿出血在ACKD中很常见，可能导致胁腹疼痛和血尿。出血性囊肿可通过其CT扫描、超声或MR成像特征来识别。出血性囊肿可能破裂进入肾周间隙，导致巨大的肾周血肿。这些通常可以保守治疗。ACKD患者，尤其是接受透析治疗的患者，患肾细胞癌的风险增加。肾移植受者移植多年后，其移植肾功能良好，但原生肾也可能发生肾细胞癌。然而，对所有透析患者或移植受者的原生肾进行年度癌症成像检查并不合理，因为尚未证明其对患者预后有显著影响。然而，对于一般健康状况良好且已知有肾细胞癌风险因素（包括长期透析、肾脏肿大、ACKD和男性）的特定透析患者，筛查可能有用。当移植受者因对肾移植进行超声评估而就诊时，可对其原生肾进行筛查。
