Renal cystic disease is characterized by expansion of renal tubules. Abnormal cell proliferation and randomly oriented cell division angle are thought to induce cystic changes in renal tubules. Recent advancements have identified many of causative genes. Interestingly, those gene products are localized in cilia or centriole, suggesting that cilia have some role to control tubular diameter. Several systemic syndromes accompany renal cystic diseases, particularly nephronophthisis. To identify nephronophthisis related pathway will be a clue to understand mechanisms to develop not only renal cysts but also phenotypes associated with ciliopathies.