Presentation
Underlying renal insufficiency, currently on dialysis.
Patient Data
Simple hepatic cysts. Absent gallbladder in keeping with the history of cholecystectomy. The common bile duct measures 17 mm and contains hyperdense material.
Multiple simple and complex cystic lesions are distributed across both kidneys, along with renal parenchymal calcifications. There is a hernia of the anterior abdominal wall containing intestinal loops and omentum, showing no signs of complication. A peritoneal dialysis catheter is present, along with a small amount of free fluid.
Free air within the abdomen.
Case Discussion
The patient has previous ultrasounds at our hospital where no renal cystic lesions are reported; however, hepatic cystic lesions are reported. The treating physician notes that approximately 5 years ago, the renal cystic lesions were reported. No changes have been observed in the hepatic cystic lesions.
Acquired polycystic kidney disease (APKD) typically develops in patients with long-standing chronic kidney disease, particularly those undergoing long-term dialysis. Unlike its inherited counterpart, APKD is characterized by the development of multiple kidney cysts as renal function deteriorates. These cysts are usually small and less numerous than those seen in autosomal dominant polycystic kidney disease.
The presence of cysts can complicate the clinical course, potentially leading to infections, hemorrhage, or rarely, malignant transformation. Management focuses on monitoring kidney function, treating complications as they arise, and addressing the underlying renal disease.
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