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| Year : 1998 | Volume
: 9
| Issue : 4 | Page : 462-463 |
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| Acquired Renal Cysts: The Other Side of the Coin |
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PT Subramanian
Hemodialysis Unit, King Fahd Central Hospital, P.O. Box 204, Gizan, Saudi Arabia
Click here for correspondence address and email
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How to cite this article:
Subramanian P T. Acquired Renal Cysts: The Other Side of the Coin. Saudi J Kidney Dis Transpl 1998;9:462-3 |
To the Editor:
Various aspects of acquired renal cystic disease [1] of the native kidneys of the patients with chronic renal failure [2] as well as of those on maintenance hemodialysis [2],[3] , along with selected abstracts on the same subjects [4] were provided to the readers in the recent issues of the journal. Here we would like to mention some other aspects of acquired renal cysts.
Renal cysts may also be acquired after infection or exposure to toxin [5] . The toxins associated with cystic diseases are concentrated in the intratubular fluid or renal epithelium [6] . "The location of such cyst varies with specific toxin. A partial list of chemicals causing renal cysts includes stilbesterol, corticosteroids, biphenyl, diphenylamine, alloxan, bacitracin, lithium chloride, lead acetate, sedormid, trichylorphenoxyacetic acid, and streptozotocin" [5] . Having known the role of some of the chemicals and therapeutic agents for the development of renal cysts, we have, also, to consider the effect of various other chemicals in the environment, and therapeutic substances for the development as well as progression of renal cysts in both healthy subjects and those with renal disease. Much work is awaited in this area to resolve the mysteries behind them.
Chapman et al (cited by Orth et al) [7] observed that an association between severe renal cystic involvement in autosomal dominant polycystic kidney disease patients and greater pack year smoking history. In an excellent review on renal risks of smoking [7] , no mention was made on the association between tobacco smoke and the development of acquired renal cyst and/or malignant transformation of those cysts in others. In fact, earlier studies revealed renal elimination of nicotine and its metabolites , susceptibility of renal tissues to Nnitrosamines (a carcinogen) [9] , covalent DNA damage of the cells of the kidney excreting those chemicals [10] , higher serum levels of nicotine in hemodialysis patients who smoke than healthy smokers [11] , and increased risk of developing renal cell carcinoma in smokers. Hence, let us ask ourselves, "will any of the products of tobacco smoke and/or its' metabolites left out or accumulated in the body of those on dialysis or not, contribute to the development of acquired renal cysts and/or trigger malignant transformation of the cyst in some of the susceptible individuals?". If the answer is yes, then intense efforts should be made to inform and educate the population.
 References | |  |
| 1. | Blagg CR. Acquired cystic renal disease. Saudi JKidney Dis Transplant 1997;8:105-12.  |
| 2. | Ghnaimat M, Jumaan R, Nimri M, El-Lozi M.Acquired cystic disease of kidney in chronicrenal failure in Jordan. Saudi J Kidney DisTransplant 1998;9:4-7. |
| 3. | Kumar R, Mislira HK. Acquired cystic renal disease in patients receiving long term hemodialysis. Saudi J Kidney Dis Transplant 1997:8:8-10. |
| 4. | Acquired cystic renal diseases. Selected Abstracts.Saudi J Kidney Dis Transplant 1997;8:166-75. |
| 5. | Maher J. Toxic and irradiation nephropathies. In:L.E. Early, C.W. Gottschalk (Eds), Strauss and Welt's, Diseases of the kidney, Third Edition, 1979, Little Brown and Company, Boston, USA, VolII,P1463. |
| 6. | Resnick JS, Brown DM, Vernier RL. Normaldevelopment and experimental models of cystic renal disease. In: K.D. Gardenr (Ed), Cystic disease of the kidney, New York; Wiley 1976: P.24 (cited in reference No. 5). |
| 7. | Orth SR, Ritz E, Schrier RW. The renal risks ofsmoking. Kidney Int 1997;51:1669-77. [PUBMED] |
| 8. | Sastry BV, Chance MB, Singh G, Horn JL,Janson VE. Distribution and retention of nicotineand its metabolite cotinine, in the rat as a function oftime. Pharmacology 1995;50(2):128-36. |
| 9. | Tjalve H. The tissue distribution and the tissuespecificity of bio-activation of some tobacco-specific and some other Nnitrosamines. Crit Rev Toxicol 1991:21(4):265-94. |
| 10. | Takenawa J, Kaneko Y, Okumara K, et al. Urinaryexcretion of mutagens and covalent DNA damage induced in the bladder and kidney after passive smoking in rats. UrolRes 1994;22(2):93-7. |
| 11. | Perry RJ, Griffiths W, Dextraze P; Solomon RJ, Trebbin WM. Elevated nicotine levels in patients undergoing hemodialysis. A role in cardiovascular mortality and morbidity. Am J Med 1984;76(2): 241-6. |
Correspondence Address:
P T Subramanian
Hemodialysis Unit, King Fahd Central Hospital, P.O. Box 204, Gizan
Saudi Arabia
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PMID: 18408321 
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