Where once PRCC was thought to be the most frequent malignancy associated with ACKD, ACD-RCC is now believed to represent the most commonly occurring RCC in patients with ACDK.
The incidence of RCC in ACKD increases with duration of dialysis and ranges from 1.6% to 8%.
Supportive care is increasingly being discussed as a treatment option because of the increasing number of older people with multiple comorbidities with ACKD (Noble, 2008).
However, the information provided to older people with ACKD regarding making choices about end-of-life care issues is limited (Berzoff et al., 2008; Davison, 2010).
ACKD develops in kidneys with long-term damage and bad scarring, so it often is associated with dialysis and end-stage renal disease.
Patients with ACKD usually seek help because they notice blood in their urine (hematuria).
A, Acquired cystic kidney disease (ACKD
)-associated renal cell carcinoma (RCC) with intratumoral oxalate crystals (arrows).
Due to the numbers of older people being diagnosed with ACKD, supportive care is increasingly being discussed as a treatment option (Noble, 2008).
To explore the peer-reviewed primary research exploring the needs of older people with ACKD who have chosen supportive care as their treatment of choice.
Bleeding is seen in up to 17% of kidneys with ACKD. (27,28) This may derive from unsupported blood vessels within the flimsy cyst walls and is promoted by uremia-associated coagulation defects or dialysis-related heparinization (about 70% of cases).
These renal neoplasms can develop from the background of ACKD and probably derive from cysts with dysplastic lining cells.
The usual indicated treatment for patients with ACKD
or AKI is renal replacement therapy (RRT), with hemodialysis as the preferred dialytic mode.