Kidney cysts

The kidney cyst is a neoplasm on the upper layer of the kidney, which is considered benign. Cystic formation is a cavity formation with a capsule and a fluid of the serous structure. Cysts can have a variety of shapes, can be simple, consisting of one cavity (chamber) or more complex - multi-chamber. As a rule, the kidney cyst does not grow to large sizes, cystic lesions more than 10 centimeters are extremely rare. The etiology of cyst development is still not specified, although this disease is often found in clinical urological practice.

[1], [2], [3], [4]

Epidemiology

The kidney cyst is most often diagnosed in men aged 45-50 years, in women they are detected much less often.

[5], [6], [7], [8], [9], [10], [11], [12],

Causes of the kidney cysts

The etiology of cyst formation is still unclear, there are several theories put forward by outstanding physicians and scientists. However, the species diversity of cysts, sometimes atypical course of the disease, late treatment for medical help and many other reasons do not yet provide an opportunity to establish a single etiological basis. One of the most common causes of cyst formation is the pathology of the renal tubule, according to which a normal outflow of urine should occur. If urine accumulates in the tubule, it stagnates, it forms a kind of protrusion of the wall and gradually becomes a cyst. Factor provoking stagnation of urine, can be any pathology and dysfunction of the kidneys - tuberculosis, concrements (urolithiasis), inflammatory process in the renal pelvis (pyelonephritis), trauma or oncology. In cysts most often there is a serous substance, often with blood, also they can be filled with kidney fluid with pus. Some cystic formations develop simultaneously with the internal tumor formation, which is localized on the walls of the cyst itself.

[13], [14], [15]

Risk factors

Among the most typical reasons that provoke neoplasms in the kidneys are the following: 

• A tumor of one or both kidneys. 
• Stones or sand in the kidneys. 
• Pyelonephritis. 
• Tuberculosis of the kidneys. 
• Venous or ischemic infarction of the kidney. 
• Damage to the fibrous capsule of the kidney, hematoma of the kidney. 
• Intoxication, including medicamentous.

[16], [17], [18], [19], [20]

Symptoms of the kidney cysts

The kidney cyst often does not manifest itself for a long time, that is, the process proceeds asymptomatically. Often neoplasms are diagnosed during the passage of an ultrasound examination, designed to detect another pathology. A small discomfort or pain in the lumbar region, periodically appearing blood in the urine, blood pressure jumps are typical symptoms of kidney pathologies. However, the symptomatology appears when the cystic formation has already developed and the process passes into the inflammatory or purulent stage. Often a person can feel a painful heaviness in the right or left hypochondrium, this is due to the fact that he pulls the kidney down. Often disturbed and urination, as the kidney cyst is pressing on the parenchyma and blocking the outflow of urine. When the parenchyma undergoes pressure, a specific hormone, renin, triggers pressure jumps. Almost all cystic formations in the early stages of development do not show themselves as clinical signs, doctors call it the "silent course" of the disease. When the size of the cysts increases, or the cysts grow, the symptoms become more pronounced and grows.

The kidney cyst can cause the following complications: 

• Education of kidney stones. 
• With severe hypothermia, the pyelonephritis of the kidney cyst can be festered. 
• The kidney cyst can burst with any trauma to the lumbar spine. 
• Cystic education can turn into a malignant form, malignant. 
• The kidney cyst can provoke kidney failure.

[21]

Forms

The kidney cyst is divided into the following types: 

• A single kidney cyst is a solitary (peripheral solitary formation). 
• A rare species that is diagnosed in 1% of all patients is congenital multicystosis. 
• Cystic transformation of the parenchyma or polycystosis. 
• Dermoid cystic formation filled with connective tissue (embryonic).

The kidney cyst can be localized in this way: 

• Located under the fibrous layer of the kidney - subcapsular (under the capsule). 
• Located directly in the tissues of the kidney - intraparenchymatous (in the parenchyma). 
• Located in the collar - in the sine of the kidney, parapelvic. 
• The kidney located in the sine is cortical.

The kidney cyst is divided into categories by cause and effect. It is a consequence of intra-uterine kidney pathologies, that is, congenital. This is especially true for children whose parents have suffered from polycystosis. In these cases, we can talk about the hereditary etiology of cysts, which can be diagnosed in the liver, ovaries, and other organs. Neoplasms diagnosed as acquired are the result of certain pathologies, renal dysfunctions, chronic diseases of the hematopoiesis system, cardiovascular diseases.

The kidney cyst can be of different structure: 

• Single-cavity neoplasm, cystic one-chambered formation. 
• Cysts with partitions, multilocular or multi-chambered.

The kidney cyst can have a content consisting of such substances: 

• Serous, serum liquid, which has a transparent consistency, yellowish tinge. Serous substance is a liquid that penetrates through the capillary walls into the cavity of cystic formation. 
• Contents in which blood contaminants are detected are hemorrhagic contents. This is typical for neoplasms caused by trauma or a heart attack. 
• Contents with pus, which can be a consequence of an infectious disease. 
• The contents can be tumorous, that is, in addition to the fluid inside, a separate internal tumor develops. 
• In the contents of cysts, stones (calcinates) are often found.

Cystic formation can be localized in only one kidney and be single, and there are also dangerous for the health and life of cystic education that affect both kidneys, they can be multiple.

Diagnostics of the kidney cysts

Neoplasms in the form of cysts are diagnosed by ultrasound. Also shown are computed tomography, magnetic resonance imaging, which give a clearer and more detailed picture of the localization and structure of the cysts. In addition, to exclude or confirm the malignant course of the disease, a radioisotope study of kidney function is used - scintigraphy, dopplerography, angiography and urography. Blood tests, both general and detailed, urinalysis are mandatory in a complex of diagnostic measures.

[22], [23], [24], [25], [26], [27]

Treatment of the kidney cysts

If the tumor is diagnosed as a result of a complex examination of another disease, which most often happens, and if the kidney cyst does not disturb the patient and does not show pain, at the first stage it requires careful observation. Treatment of cysts begins only when it changes the function of the kidney and interferes with its normal functioning, for example, a large cyst of the kidney can press on nearby tissues, disrupt their blood circulation. Cystic formations up to 40-45 mm do not operate, their condition is controlled by ultrasound scanning, which is shown to be performed every six months. Symptomatic therapy is indicated in cysts that are accompanied by pyelonephritis, provoke hypertension or CRF - chronic renal failure. In cases where they grow to large sizes, significantly impair the functioning of the kidneys, they operate. Surgical intervention can be carried out in ways that depend on the size and dynamics of growth of neoplasms, it can be laparoscopic or in the form of a puncture. Most often, when the kidney cyst is diagnosed in a timely manner, a method of percutaneous puncture or punctures with further sclerotherapy is applied-the introduction of a special drug that "glues" the walls of the cavity of cystic education. These interventions are accompanied by ultrasound control, are absolutely safe and low-traumatic. Larger formations are operated using laparoscopy, the technique of which directly depends on where the kidney cyst is located. Laparoscopy is performed using a special endoscope, which is introduced into a small incision at the level of cyst localization.

Surgical operations are indicated in such cases: 

• With a strong pain syndrome. 
• With a significant impairment of kidney function. 
• With arterial hypertension, which can not be controlled by drug therapy. 
• If there are all signs of malignancy of cystic education. 
• If the size of the tumor exceeds 40-45 millimeters. 
• If parasitic etiology is revealed.

The kidney cyst, no matter how it is treated, requires a strict diet: 

• Restriction of salt in the diet, the exclusion of consumption of salty foods. 
• Control of fluid intake, especially with progressive swelling. 
• Restriction of the use of protein foods. 
• Exclusion from the diet of cocoa products, coffee, sea fish and seafood. 
• Refusal from pernicious habits - alcohol and smoking.

Forecast

• If multi-education is diagnosed on both kidneys of an innate nature, the prognosis is unfavorable. Neoplasms are not compatible with life. 
• Congenital autosomal recessive cystic formations also have an unfavorable prognosis, children rarely survive to two months of age. 

The kidney cyst, which is diagnosed as simple, has a virtually 100% positive prognosis, regardless of the way it is treated - outpatient (medical) or surgical intervention.

[28], [29], [30],