Kidney Cysts
I have been detected with Cysts in my Kidney. Is it dangerous?
Simple Cysts:
Simple Kidney cysts can form at all ages ranging from the foetal stage when the mother is still pregnant to childhood, young and older age.
1- Foetal stage: Cysts form due to genetic disorders. some like MCDK and ARPKD are dangerous to the survival of newborn due to early renal failure.
2- Childhood stage: Cysts are rare in this age and can be sometimes delayed presentation of a genetic disorder.
3- Young adulthood: Upto 1-2 simple cysts can normally form and are of no consequence. except for Genetic disorder cases like ADPKD where they are associated with cysts in other organs like Liver and Pancreas.
4- Middle age: In cases of ADPKD number of cysts increase in all organs with age and can result in renal failure by the age of 50s.
5- Elderly age: Half of the population above age of 50 can have a few simple cyst in kidneys and are of no consequence

Complex renal Cyst
Complex cysts are dangerous and are usually seen in adults at any age. they can be a precursor of cancer or can be cancerous depending upon the complexity of cysts.


Evaluation:
Ultrasound Abdomen: Good enough to detect simple cysts in Kidney liver& Pancreas.
CECT KUB: A CT Scan is needed in cases where ultrasound suspects a complex renal cyst.

Management:
1- Simple cysts: most cases need no treatment unless symptomatic. can be treated for an infection or in case they are very large and causing pain, then they can be managed by Laparoscopic cyst deroofing.
2- Cystic disease like ADPKD need control of Diabetes, Infection and hypertension in order to delay renal failure. once the failure has happened patient will need renal replacement therapy in the form of dialysis or a kidney transplant. rarely if kidneys re very large then they might need to be removed in order to make space for transplant kidney.
3- Complex cyst treatment is based on complexity and up to type 2 cysts can be simply observed. while cysts which have complexity level 3-5 will need to be considered cancerous hence need to be tackled accordingly with Surgery.
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