Acquired Cystic Kidney Disease in Chronic Hemodialysis Patients: A Multicenter Study in Dakar

Abstract

Introduction : The prevalence of acquired cystic kidney disease (ACKD) varies according to the duration of dialysis. Few studies are available on this subject in sub-Saharan Africa. The objective of this study was to determine its prevalence, define its clinical profiles and ultrasound characteristics, and identify factors associated with its development. Patients and Methods : This was a multicenter, cross-sectional, descriptive, and analytical study conducted over seven months in three hospitals in Dakar. Included were chronic hemodialysis patients aged 18 years or older, with a duration of dialysis exceeding three years, and in whom renal ultrasound revealed at least three acquired cysts in each kidney. Results : The prevalence of ACKD was 30.37%. The mean age of the patients was 51.49 ± 13.4 years, with a male-to-female ratio of 2.15. Hypertensive nephropathy was the most common nephropathy, accounting for 39.03% of cases. The average session duration was 3.93 ± 0.26 hours, and the frequency was 3 or 4 times per week. Lower back pain was present in 34.3% of patients, while no patient experienced episodes of macroscopic hematuria. The mean hemoglobin level was 10 ± 1.9 g/dL. Corticomedullary cysts were the most frequent, occurring in 46.34% of cases, followed by medullary cysts in 31.71%, with 21.95% of patients having cortical cysts. The mean number of cysts in the right kidney was 6.93 ± 3.72, and in the left kidney, the mean was 6.27 ± 3.03. The mean cyst size was 22 ± 8.06 mm. Factors associated with the development of ACKD included male sex, duration of dialysis (over 60 months), low diastolic blood pressure, low dose dialysis, and a hemoglobin level greater than 10 ± 1.9 g/dL. Conclusion : This study identified factors associated with the development of acquired cystic kidney disease in hemodialysis patients in our setting. Regular screening is necessary for patients on hemodialysis for more than 3 years to prevent certain complications, particularly renal cell carcinoma.