Cystic Diseases of the Kidney



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
  • On exam the kidneys may be palpable
  • 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

Content by Dr Íomhar O' Sullivan 29/11/2004. Reviewed by Dr ÍOS 26/05/2006, 26/05/2007. Last review Dr ÍOS 12/08/22.