Renal Cystic Disease

Renal cystic diseases refers to a multitude of pathologies that shares one common trait – i.e. formation of multiple cysts in one or both kidneys leading to a wide range of pathological issues. Cyst formation is characterized by formation of fluid-filled sac like small cavities in the tissues. These cavities are often filled with a semi-solid or fluid material; while the cavity walls are lined with a special type of epithelium. When these cysts are formed inside the renal or urinary tissue; the condition is referred to as renal cystic diseases.It is imperative to mention that most cases of renal cystic diseases are genetically acquired and are often associated with other congenital anomalies as well.

Classic Symptoms of Renal Cystic Diseases?

The symptoms of renal cystic disease vary according to site of disease and its severity. Discussed below are some characteristic symptoms of most frequently reported renal cystic disease.

1. Autosomal dominant polycystic kidney disease (ADPKD):

• Appearance of blood in urine, also referred to as hematuria.
• Persistent dull flank pain
• Renal infections
• High blood pressure (this is usually observed in patients with old age)
• Kidney stones

2. Autosomal Recessive Polycystic kidney Disease:

• This condition is usually associated with congenital anomalies of the liver (cystic liver disease)
• In most cases, symptoms are usually evident during infancy period.
• Patients usually develop high blood pressure at an earlier age that may aggravate the risk of sudden cardiac death or other cardiovascular complications.
• Growth retardation
• Most cases are diagnosed at an earlier age due to severity of symptoms (usually at an age of 4-8 years).
• Associated renal diseases are also present
• Other common complications are; recurrent episodes of esophageal bleeding, bacterial infections, cholangitis and low platelet count.

3. Nephronophthisis Medullary Cystic Disease:

Common symptoms include:

• Bone deformities
• Growth retardation
• Vision loss
• Progressive retinal degeneration
• Anemia
• Increased urine flow

4. Acquired Renal Cysts:

Common symptoms include:

• It is common in patients with hemodialysis
• Hematuria (blood in urine)
• Flank pain

5. Simple Renal Cysts:

Patients with simple renal cysts usually presents with:

• Pain in both sides of abdomen
• Blood in urine

6. Medullary Sponge Kidney Disease:

Patients usually presents with:

• Increased calcium levels
• Hematuria with flank pain

7. Malignant Renal Cysts:

Patients presents with:

• May progress to renal carcinoma
• Weight loss
• Fever
• Hypertension
• Fatigue and hematuria

8. Congenital Cysts:

These cysts are present at birth and may present with non-specific sign and symptoms. Most patients may develop signs and symptoms of renal failure during infancy.

What Causes Renal Cystic Diseases In Patients?

• These cysts are usually inherited (i.e. transferred by either or both parents)
• In some cases, renal cystic diseases may be acquired as part of other issues or ailments.

Certain risk factors that may aggravate your risk of developing renal cystic diseases are:

• Positive family history of renal diseases
• Positive history of genetic mutations or syndromes
• Chronic drug abuse
• History of cyst formation in other organs
• Extremes of age

Diagnosis of Renal Cystic Disease

Following are some detection tests that are very frequently used for the diagnosis of respective renal cystsCongenital cysts:

• It can be diagnosed through sonogram during pregnancy.
• Congenital cysts are also diagnosed via pyelogram and X-ray
• The diagnosis can also be made by locating a palpable mass in the flank region

Autosomal Dominant Polycystic kidney Disease

• Gene analysis is done to identify the hereditary cases.
• Sonogram can also be used for diagnosis

Autosomal Recessive Polycystic Disease

• Detection through urine analysis (by detecting low sodium levels in urine)
• CT scan and ultrasound for locating and identifying the position of cysts

Nephronophthisis Medullary Cystic Disease

• Urine analysis
• Gene analysis
• CT scan and sonography (a diminished kidney is observed)

Acquired Renal Cysts

• Diagnosis is usually made through CT scan and MRI (magnetic resonance imaging)

Simple Renal Cysts

• X-ray is performed for identification of cysts
• CT scan is done to differentiate between a benign and malignant cyst

Medullary Sponge kidney

• IV (intravenous) pyelogram

Malignant Cysts

• MRI (magnetic resonance imaging)
• IV (intravenous) pyelogram

References:

1. Rule, A. D., Sasiwimonphan, K., Lieske, J. C., Keddis, M. T., Torres, V. E., & Vrtiska, T. J. (2012). Characteristics of renal cystic and solid lesions based on contrast-enhanced computed tomography of potential kidney donors. American Journal of Kidney Diseases, 59(5), 611-618.
2. Avni, F. E., Garel, C., Cassart, M., D’Haene, N., Hall, M., & Riccabona, M. (2012). Imaging and classification of congenital cystic renal diseases. American journal of roentgenology, 198(5), 1004-1013.