ABSTRACT
Cystic disease of the kidneys has multiple aetiologies. The cysts are either dilated renal tubules or diverticulum-like structures that arise from renal tubules. They may be connected to the rest of the nephron or they may have lost their continuity. Very few cause hypertension and malignancy has been reported very rarely in the paediatric age group. Autosomal recessive polycystic kidney disease can be diagnosed antenatally when there are bilateral renal cysts causing renal enlargement. The kidneys may become so huge that vaginal delivery is impossible. The pelvicalyceal system is absent and the cysts are attempts at formation of the collecting tubules. There is little or no renal tissue. Histologically they display primitive ducts, concentric rings of connective tissue, collagen and occasional metaplastic cartilage. Multicystic dysplastic kidneys are sporadic and do not have a genetic basis. Normally, the nephrogenic blastema is stimulated by the ureteric bud to induce formation of a kidney.
