American Board of Internal Medicine (ABIM) Certification Practice Exam

Acquired cystic kidney disease is associated with an increased risk for which type of cancer?

1. Bladder cancer

2. Liver cancer

3. Renal cell carcinoma

4. Prostate cancer

The correct answer is: Renal cell carcinoma

Acquired cystic kidney disease (ACKD) is commonly observed in patients with chronic kidney disease (CKD), particularly those on long-term dialysis. One of the significant concerns associated with ACKD is its association with an increased risk of renal cell carcinoma (RCC). The development of numerous cysts in the kidneys can lead to cellular changes and dysregulation, creating an environment conducive to oncogenic transformations. These changes stem from the underlying renal parenchyma's chronic injury and the consequent regenerative processes that take place within cystic kidneys. Furthermore, long-standing renal failure or dialysis can further exacerbate these risks. The occurrence of RCC in patients with ACKD is recognized and supported by studies showing a higher incidence of this malignancy in such populations compared to their counterparts without kidney disease. Regular monitoring and vigilance in these patients are essential to catch any early signs of malignancy, allowing for timely intervention. In contrast, the other options presented do not have a direct, well-established link to ACKD. While bladder cancer and prostate cancer are known to be influenced by various risk factors, they are not specifically associated with the cystic changes observed in ACKD. Similarly, liver cancer does not have a recognized connection with this specific kidney disease. Thus