[Computer tomography of the kidneys after long-term dialysis]

In patients with chronic kidney failure in the long-term dialysis programme multiple minute cysts frequently develop in the shrunken kidneys. In addition to the cysts, in 20% of patients there are also multiple kidney tumours causing severe complications. In most cases the clinical picture of the disease is insignificant, hematuria being the most frequent manifestation. The authors present their cohort of 21 patients with irreversible kidney failure, who have been examined by computer tomography in the 1986-1987 years. The mean period of dialysis programme was 5.7 years, chronic glomerulonephritis and interstitial nephritis being the basic disease. The patient were, according to the results of computer tomography, divided into four groups: 1. the presence of cysts or tumours was not demonstrated, 2. multiple cysts were found in bilateral localization, 3. less than 3 cysts were found, 4. there was a kidney tumour. A factor causing the development of the cysts has not yet been identified. It is presumed that the disease is caused by a biologically active substance which is not efficiently dialyzed. On the basis of the present work the authors recommend the aimed examination of the kidneys in patients at the stage of chronic kidney insufficiency and particularly in patients subjected to dialysis for long period of time. The recommended examination is by computer tomography and the attention should be centered to possible occurrence of acquired cystic disease of kidney tumours.