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Proliferative Epithelial Lesions Associated With End-Stage Renal Disease

Abstract Kidney changes seen in end-stage renal disease, after a period of chronic progressive renal disease, may to give rise to different benign and malignant epithelial proliferative lesions. These epithelial proliferations are many times associated with dialysis, but not necessarily so. Many of these lesions are part and parcel of acquired cystic kidney disease. These may also happen without prior cystic changes. A review of the literature is presented, and the different proliferative lesions discussed. Lesions such as hyperplasia of the Bowman capsule classified as embryonal because of the primitive appearance of the cells, which may or may not form tubular structures, are described. Lesions such as unusual epithelial proliferations within the lining of cysts and endothelial and granular metaplasia noted in patients with hypertension where a hyperplasia of renin-producing cells is seen in the juxtaglomerular apparatus are covered in this article. Patients with end-stage renal disease, especially those on dialysis, can develop acquired cystic kidney disease, and some of the cysts can exhibit atypical epithelial proliferations with multiple layers and pseudopapillary formations. Neoplasms whether benign or malignant are also associated with end-stage kidney disease; these seems to have a predominance of papillary neoplasms, which occur more often than in sporadic tumors. Although these tumors, for the most part, share similar histological appearance with the sporadic ones, these have different molecular imprints.