Acquired cystic kidney disease is incidentally noted with characteristic numerous small parenchymal cysts, most of them are less than 5 mm. The appearance can mimic autosomal dominant polycystic kidney disease which is also a cause of late onset of end stage renal disease. So, history of the new development of these cystic changes after dialysis is important to establish the diagnosis.

This case was referred to investigate jaundice (MRCP), the intra- and extra-biliary radicals are normal. In the presence of established cirrhotic liver change, cholestatic jaundice was suggested.