Cystic Diseases of the Kidney
- Simple cysts of the kidneys are common.
- Usually single and unilateral. Most are asymptomatic and found incidentally during radiologic
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.
- 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 hemorrhage 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
