Background
Simple cysts
- Simple cysts of the kidneys are common
- Usually single and unilateral. Most are asymptomatic and found incidentally during radiological investigations done for other reasons
- Physical exam, urinalysis and renal function tests should all be normal
- Simple cyst are not an explanation for Haematuria
- If there is any reason to believe that the lesion is not a simple cyst, a CT scan of the abdomen should be requested
- No treatment is needed for simple renal cysts but patients with atypical or complex cysts should be referred to a urologist
Polycystic Disease
Adult polycystic kidney disease - APCKD - is an autosomal dominant hereditary condition causing multiple bilateral renal cysts.
Flank pain is common and is secondary to either obstruction, infection, stones or haemorrhage into a cyst.
- Symptoms usually do not develop before the age of 40
- A family history is often present
- The kidneys may be palpable on examination
- Hypertension is present in the majority of patients
- Urinalysis reveals proteinuria and at least microscopic Haematuria
- Abdominal ultrasound is capable of making the diagnosis, but CT scan is more accurate
- Renal failure is the rule within 5 to 10 years of presentation
- Patients should be placed on low protein diet
- Their hypertension should be adequately controlled medically. Infections should be treated promptly and aggressively
- When their renal function has deteriorated to the point that they are symptomatic, dialysis should be started
- Renal transplant is also a consideration