Abstract : Acquired cystic kidney disease (ACKD) is characterized by small cysts distributed throughout the renal cortex and medulla of patients with ESRD unrelated to inherited renal cystic diseases. Its prevalence and severity are higher in men than in women [7:1] and increase with the duration of azotemia. Children are also prone to the development of ACKD. The study was cross sectional in nature & was undertaken to study the prevalence of cystic changes in patients with chronic kidney disease on maintenance hemodialysis in tertiary care hospital over a period of one year. Radiological imaging was done using Computerized tomography. CT KUB / plain was done for patients to look for acquired renal cysts. Kidney size, the number of cysts & size of cysts as seen by CT KUB were noted The modified Bosniak classification. Analysis of the data was performed using statistical package for the social sciences (SPSS) software. Out of the 50 patients who underwent imaging 32 patients i.e 64% (22 males &10 females) had cystic changes representing presence of one or more cysts, where as 18 i.e 32%, (16 males & 2 females) did not show any cysts. R-Square statistic is 0.335, which is good, indicating that 33.5% of the total variance is explained by best fitting linear regression equation. The model itself is significant at 99.9% as indicated by F-Statistic from ANOVA (in the subsequent table). Overall, this indicates that there is indeed a strong relation of the variables with average number of cysts. Cystic changes, as defined by presence of one or more cysts in one or both kidneys are common (64%) in CKD V patients on maintenance hemodialysis. Acquired cystic kidney disease, as defined by the presence of 4 or more cysts in each kidney is relatively not as common.