Kidney Cyst is the generic terms of big or small cystic masses in the kidney which have no communication with the outside world. The common Kidney Cysts include Adult Polycystic Kidney, Simple Renal Cyst and Acquired Cystic Kidney. Kidney Cyst may appear in one side or both sides, so Kidney Cysts can also be divided into Left Renal Cyst, Right Renal Cyst and Bilateral Renal Cyst.
What are the clinical symptoms of Kidney Cyst?
① waist, abdomen discomfort or pain: dull pain on one side or both sides, down back to abdomen or waist. And intracystic bleeding or secondary infection will intensify the pain suddenly. If it’s combined with kidney stone or blood clots blocking urinary tract , renal colic may occur.
② hematuria: microscopic hematuria or gross hematuria. It can be cyclical. When it occurs, waist pain will be intensified. Strenuous exercise, trauma, infection can induce or aggravate hematuria.
③ abdominal bossing: sometimes it is the main reason for patients to see a doctor and 60 ~ 80% of it can reach enlarged kidneys.
④ proteinuria: it can occur in some patients and usually the amount is small.
⑤ hypertension: the cysts oppress the kidney, causing renal ischemia and then hypertension. When renal function declines, the incidence of hypertension will be higher.
⑥ declined renal function: because of the oppression and occupation of the cyst, the normal kidney tissues will reduce significantly and renal function will decline progressively.
Examination of Kidney Cyst
a. Examination of urine. Normal Urine Routine, if renal parenchyma is pressed in the cyst, or has concurrent infection in the cyst, there may appear small quantity of RBC (Red Blood Cells) and WBC (White Blood Cells).
b. The amount, size of cyst and situation of cyst wall can be realized by B-ultrasonic, and it can be distinguished with Renal Mass, which is as the first choice examination method. The typical manifestation of B-ultrasonic is that there is no echo in the lesion with smooth cyst wall and clear edge. If the test shows irregular echo on cyst wall, or has increasing focal echo, patient should notice the malignization. Secondary infection may thicken cyst wall, and there has tiny echo in the lesion, which may be enhanced when bleeding in the cyst. When video picture prompts multi-cyst, it should be distinguished from Multilocular Cyst and Polycystic Kidney.
c. Intraveneous Pyelography can show the extent of renal parenchyma by cyst, and it can be distinguished from Hydronephrosis.
B. Further examination
CT Examination is useful for the patient who can’t be diagnosed the disease by B-ultrasonic. CT shows inhomogeneity with increasing value if the cysts accompanies with haemorrhage, infection and malignancy. Patients needn’t to take cystic puncture when CT shows the symptoms of cyst.
C. Diagnostic highlights:
a. Kidney Cyst usually has no symptom in the early stage, which is often found by B-ultrasonic. When the cyst is over 10 cm, it can cause symptoms.
b. Cystic bumps can be seen in the waist and abdomen.
c. B-ultrasonic can make the definite diagnosis. Patients can adopt further examination if they have doubt about malignancy.
d. Kidney Cyst should be distinguished from Kidney Cancer, Hydronephrosis, Multilocular Cyst of kidney and Polycystic Kidney.