Are kidney cysts serious? The harm of kidney cyst

The occurrence of renal cysts has a great impact on kidney health, because the symptoms themselves affect the entire body, such as low back discomfort, hematuria, proteinuria, high blood pressure, etc. If these conditions worsen, they will threaten the patient's life. Kidney cyst is a relatively serious disease, so patients should seek medical treatment in time.

① Discomfort or pain in the waist and abdomen: The reason is that the enlarged and expanded kidneys increase the tension of the renal capsule, pull the renal pedicle, or cause compression of adjacent organs. In addition, polycystic kidneys cause the kidneys to contain a lot of water, become heavy and pull, and can also cause low back pain. The pain is characterized by dull pain. Fixed on one or both sides, radiating to the lower part and lower back. If there is intracystic bleeding or secondary infection, the pain will suddenly intensify. If there is combined with stones or blood clots blocking the urinary tract after bleeding, renal colic may occur.

②Hematuria: It may manifest as microscopic hematuria or macroscopic hematuria. The onset is cyclical and the low back pain often worsens during an attack. Vigorous exercise, trauma, and infection can induce or aggravate it. The reason for bleeding is that there are many arteries under the cyst wall. Due to increased pressure or combined infection, the blood vessels in the cyst wall are over-stretched and ruptured and bleed.

③ Abdominal mass: Sometimes it is the main reason for patients to seek medical treatment. Generally speaking, 60%-80% of patients can feel the enlarged kidney. The larger the kidneys, the worse the kidney function.

④ Proteinuria: The amount is generally not much, and will not exceed 2g per hour in urine. Most patients will not develop nephrotic syndrome.

⑤ Hypertension: Solid cysts compress the kidneys, causing renal ischemia, increasing renin secretion and causing hypertension. When renal function is normal, more than 50% of patients develop hypertension, when renal function is impaired. The incidence of hypertension is higher.

⑥ Renal function decline: Due to the space-occupying and compression of the cyst, the normal renal medical tissue is significantly reduced, and the renal function declines progressively.

Differential Diagnosis

(1) Kidney cancer: It is a space-occupying lesion, but it tends to occur deep inside, thus causing more obvious calyceal curvature. Hematuria is common, but cysts are not. When the renal parenchymal tumor is pressed on the psoas major muscle, the edge of the muscle cannot be seen on the abdominal plain film, but the cyst is still visible. Evidence of metastasis (eg, weight loss, fatigue, palpable supraclavicular lymphadenopathy, metastatic nodules on chest X-ray), polycythemia, hypercalcemia, and elevated erythrocyte sedimentation rate all suggest cancer.

It is important to remember that the cyst walls can also become cancerous. If the renal vein is blocked by cancer, excretory urography will be unclear or even not visible. Ultrasound imaging and CT are always used as a last resort for differential diagnosis. Angiography and renal tomography may show a dense "pool" of contrast agent in a richly vascularized tumor, while the density of the cyst is not affected. It is wise to presume that all renal space-occupying lesions are cancer until proven otherwise.

(2) Polycystic kidney disease: As shown by urography, the disease is almost always bilateral, with diffuse distortion of the renal calyces and renal pelvis becoming a regular pattern. Simple renal cysts are mostly solitary. Polycystic kidney disease is often accompanied by renal impairment and hypertension, while renal cysts are not.