Acquired cystic kidney disease (ACKD) increases the risk of renal malignancy, and many authors suggest routine screening of dialysis patients for ACKD and renal tumors. However, they have defined neither the target population, the optimal screening strategy, the magnitude of its benefit, nor its risk. We used decision analysis to evaluate strategies of performing either computed tomography (CT) or ultrasound every three years on all dialysis patients and annually on patients found to have cysts. We compared these strategies to a strategy of seeking cysts and cancer only if these are clinically suspected. The baseline analysis shows that both CT and ultrasound may decrease cancer deaths by half for patients with a life expectancy of 25 years. Screening for ACKD offers these patients as much as a 1.6 year gain in life expectancy. However, for the majority of patients beginning renal replacement therapy, age or comorbid disease substantially limits life expectancy. For such patients, the gain in life expectancy from an ACKD screening program is measured in days. Sensitivity analyses show that the benefit of screening depends on the rate of malignant transformation, which needs better definition. The gain in life expectancy does no...Continue Reading
Acquired cystic disease of the kidneys: a hazard of long-term intermittent maintenance haemodialysis
Cost-effectiveness of screening and early treatment of nephropathy in patients with insulin-dependent diabetes mellitus.
Natural history of acquired renal cystic disease in dialysis patients: a prospective longitudinal CT study
Metastatic renal cell carcinoma associated with acquired cystic kidney disease 15 years after successful renal transplantation
Functional status and quality of life: predictors of early mortality among patients entering treatment for end stage renal disease
Changing risk factor demographics in end-stage renal disease patients entering hemodialysis and the impact on long-term mortality
Detection of renal masses: sensitivities and specificities of excretory urography/linear tomography, US, and CT
Chronic renal failure: a significant risk factor in the development of acquired renal cysts and renal cell carcinoma. Case reports and review of the literature
Renovascular operations in patients with chronic renal insufficiency: do the benefits justify the risks?
Cost-effectiveness of screening for detection of small hepatocellular carcinoma in western patients with Child-Pugh class A cirrhosis
Prospective pretransplant ultrasound screening in 206 patients for acquired renal cysts and renal cell carcinoma
Should screening for acquired cystic disease and renal malignancy be undertaken in dialysis patients?
Clinical symptoms predict poor overall survival in chronic-dialysis patients with renal cell carcinoma associated with end-stage renal disease
Long-term online hemodiafiltration does not reduce the frequency and severity of acquired cystic kidney disease in hemodialysis patients
Use of mammalian target of rapamycin inhibitors after failure of tyrosine kinase inhibitors in patients with metastatic renal cell carcinoma undergoing hemodialysis: A single-center experience with four cases
Incidence, predictors and associated outcomes of renal cell carcinoma in long-term dialysis patients
Renal cell carcinoma in acquired cystic kidney disease: volume growth rate determined by helical computed tomography
Renal cell carcinoma detected by screening shows better patient survival than that detected following symptoms in dialysis patients
Hepatic resection versus radiofrequency ablation for hepatocellular carcinoma in cirrhotic individuals not candidates for liver transplantation: a Markov model decision analysis
Comparison of acquired cystic kidney disease between hemodialysis and continuous ambulatory peritoneal dialysis
Acquired cystic kidney disease and renal cell cancer after transplantation: time to rethink screening?
KDIGO Clinical Practice Guideline on the Evaluation and Management of Candidates for Kidney Transplantation.
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