skip to main content

ACKD Solid Mass RCC Risk Surveillance — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

HardHaemodialysisACKD Solid Mass RCC Risk SurveillanceESENeph

A patient on dialysis for 11 years has acquired cystic kidney disease. Surveillance imaging shows a new 2.8 cm enhancing solid lesion in a native kidney. What is the next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Renal-mass imaging followed by urological team assessment

Explanation lettering: D = shown as A · A = shown as B · E = shown as C · C = shown as D · B = shown as E

B is correct. Long dialysis exposure and acquired cystic kidney disease increase RCC risk; a new enhancing solid lesion therefore requires proper renal-mass characterisation and urological review. A treats a solid enhancing mass as a benign cyst. C and D infer infection without a compatible clinical or radiological pattern. E risks transplantation in the presence of an uncharacterised possible malignancy. Contrast modality is selected with radiology for the patient’s residual function and dialysis circumstances. Biopsy, surveillance, ablation or nephron-sparing surgery then depends on imaging, size, comorbidity and transplant plans rather than a reflex nephrectomy.

Reference: KDIGO 2020 transplant-candidate guideline: https://kdigo.org/wp-content/uploads/2026/04/KDIGO-2020-Transplant-Candidate-Guideline.pdf