[Acquired cystic renal changes--a clinically relevant problem in long-term dialysis].

While dialysis patients survive renal failure for years and even decades, multiple morphologic alterations take place in their kidneys. One of these (so to speak) "postmortem" changes is the formation of secondary renal cysts. A patient with end stage renal failure due to amyloidosis is described who was dialysed at home for 9 years. Intravenous pyelography and renal biopsy in the predialysis period likewise documented the presence of amyloidosis and the absence of cystic disease. Ultrasonography of both kidneys, a suspicious increase in hematocrit and the autopsy finding of numerous large cysts also showed the presence of acquired cystic disease. The frequency and complications of this newly recognized disease in longterm dialysed patients are discussed. Recommendations are given concerning follow-up of these patients, with a view to early detection of tumor development within the cysts.