Kidney cyst
The content of the article:
- Why cysts appear in the kidneys
- Classification
- Kidney cyst symptoms
- Complications and consequences
- Diagnostics
- Treatment
- Alternative methods of treating kidney cysts
- Forecast
- Prevention
- Video
A kidney cyst is a benign neoplasm, which is a spherical cavity filled with fluid contents. This disease occurs in the practice of urologists and nephrologists quite often. According to statistics, approximately 25% of adults over the age of 45 have cystic changes of varying severity. Men get sick several times more often than women. In children, kidney cysts are usually congenital.
A kidney cyst may not appear in any way, but it can also lead to serious impairment of renal function.
Why cysts appear in the kidneys
The pathological mechanism of the emergence of space-occupying lesions in the renal tissue is based on impaired growth and development of interstitial (connective) and epithelial tissue caused by an inflammatory process or damage. The main causes of kidney cysts are:
| Cause | Development mechanism |
| Renal tissue damage | Any inflammatory diseases (tuberculosis, pyelonephritis, glomerulonephritis), tumor processes, infarction (ischemia) provoke changes in the epithelial tissue that forms the nephron tubule. As a result of this, a cavity is formed in the medulla, which is gradually filled with fluid. |
| Age | With age, lesions gradually accumulate in the renal tissue, caused by various slightly pronounced pathological processes, which leads to the appearance of cavity formation. |
| Congenital factors | The cause of cystic formations can be genetic mutations or abnormalities in the formation of renal tissue at the stage of embryonic development. |
| Systemic diseases | Various systemic diseases (diabetes mellitus, obesity, arterial hypertension) cause a deterioration in the blood supply to the organs of the urinary system. In turn, this leads to the proliferation of connective tissue, as less sensitive to hypoxia |
| Localized destruction of renal tissue | Purulent processes (abscess, carbuncle) lead to purulent tissue fusion, cavity formation |
Trauma, sclerotic or inflammatory process lead to the separation of part of the tubule from its main part. If at the same time the isolated area is not sclerosed, then a small bubble, 1–4 mm in diameter, forms in its place. It is filled with a liquid whose composition is similar to that of blood plasma or primary urine. Further division of epithelial and connective tissue cells leads to a gradual growth of the cyst, the maximum size of which can reach 12-15 cm.
Over time, the mass begins to squeeze the surrounding tissue. In some cases, this process is accompanied by the formation of secondary cavities. With a significant size of the neoplasm, nerve bundles and blood vessels are compressed, and urine outflow worsens. This becomes the reason for the appearance of a number of general and local signs of a kidney cyst, which include:
- pain in the lumbar region;
- increased body temperature;
- nausea;
- headaches;
- fluctuations in blood pressure.
In some cases, there may be a malignancy of the epithelial cells lining the formation capsule from the inside.
Classification
Taking into account the peculiarities of the morphological structure, several types of kidney cysts are distinguished:
| View | Features: |
| Solitary cyst |
It is the most common form of the disease. In the photo it looks like a thin-walled single-chamber cavity, inside which there is a serous fluid. Its dimensions range from 5 mm to 12 cm. The disease is usually unilateral, that is, either the right or left kidney is affected |
| Multilocular cyst | The disease is most often hereditary. Inside, the chamber is divided into separate cavities by connective tissue partitions. There is a high risk of malignancy |
| Polycystic | The disease develops as a result of congenital malformations of the urinary system. The pathological process affects both kidneys and is characterized by the formation of multiple cysts of various sizes and shapes in them |
Kidney cysts can be located:
- in the thickness of the tissue (intraparenchymal);
- under the capsule (subcapsular);
- in the area of the pelvis;
- in the gate area.
The most important characteristics of the disease that affect the choice of treatment method and its prognosis are the location, size and nature of the neoplasm.
Kidney cyst symptoms
The disease is asymptomatic for a long time. This is due to the slow growth of the tumor, which allows the kidneys to adapt to its existence and maintain its functionality. But after the neoplasm becomes of significant size, it begins to affect the juxtaglomerular apparatus. As a result of this, the patient's blood pressure rises, headaches, cardialgia, tachycardia appear.
When the tumor compresses the nerve trunks, the patient develops pain in the lumbar region.
Large neoplasm compresses the ureter and / or reduces the volume of the renal pelvis. This causes disturbances in urodynamics, which is clinically manifested:
- decrease in urine output;
- the appearance of blood in the urine (hematuria);
- increased urge to urinate;
- pain in the lumbar region, radiating to the external genital area.
With long-term disorders of urodynamics, intoxication develops. It is characterized by the following symptoms:
- increased fatigue;
- general weakness;
- nausea;
- decreased appetite;
- swelling.
Chronic renal failure (CRF) can develop with bilateral damage or damage to a single kidney.
Complications and consequences
Most often, the disease is complicated by the development of suppuration, which proceeds as a severe pyelonephritis or abscess. In this case, the patient has the following symptoms:
- a sharp increase in body temperature up to 39-40 ° С;
- tremendous chills;
- severe headache and lower back pain;
- nausea, vomiting;
- lack of appetite;
- severe weakness.
When the capsule ruptures, the liquid contents of the formation are poured into the retroperitoneal space or the calyx-pelvic system. This condition is quite dangerous, as it threatens development:
- urinary tract infections;
- bleeding;
- hemorrhagic or infectious toxic shock.
In the long term, cavities can transform into a malignant tumor or cause chronic renal failure.
Diagnostics
It is possible to assume the presence of a neoplasm in the kidneys on the basis of a rise in blood pressure unexplained by other reasons, the presence of some changes in the general analysis of urine. To confirm the diagnosis, the patient is referred for a consultation with a urologist, who, after the examination, prescribes the necessary examination, which includes the following methods of instrumental diagnostics:
- Ultrasound;
- contrast-enhanced computed tomography;
- excretory urography;
- dynamic scintigraphy.
Computed tomography is one of the methods for diagnosing renal cysts
Also, the survey plan includes laboratory research methods:
- general urine analysis;
- test of Nechiporenko;
- Zimnitsky test;
- general blood analysis;
- biochemical blood test (urea, creatinine);
- Rehberg's test.
Treatment
With a single subcapsular or intraparenchymal cyst of the kidney, the diameter of which does not exceed 5 cm, the patient needs only dynamic observation by a urologist. The need to treat this form of the disease arises only if:
- increase in tumor size;
- the appearance of clinical symptoms (disorders of urodynamics, back pain).
Multi-chamber cavity neoplasms are subject to compulsory treatment, since there is a high risk of their malignancy, as well as formations located in the area of the pelvis or the hilum of the kidney (due to their violation of the outflow of urine).
Surgery to remove a kidney cyst is performed using one of the following methods:
- Puncture percutaneous aspiration. Under ultrasound control, the doctor makes a puncture of the capsule, passing the needle through the skin and soft tissues. After that, its contents are sucked off. This method of treatment is indicated for single-chamber solitary cysts, the size of which does not exceed 6 cm. Its disadvantage is the frequent recurrence of the disease.
- Sclerotherapy. This type of treatment is a type of puncture aspiration. After removing the liquid contents, special drugs are injected into the cyst cavity, which cause sclerosing (sticking) of its walls. This can significantly reduce the risk of recurrence.
- Excision. Allows you to completely remove the neoplasm along with its capsule. It is carried out either by an open method or using an endoscopic technique. Indications for surgery are: multi-chambered and large cavity formations, severe suppuration, bleeding, capsule rupture.
- Nephrectomy. It is performed with huge neoplasms or with significant damage to the kidney tissue. The operation can only be performed if there is a normally functioning second kidney.
In order to eliminate certain symptoms of the disease, drug therapy is carried out. Patients can be prescribed different groups of drugs:
- non-steroidal anti-inflammatory drugs - reduce the activity of inflammation, relieve pain, have an antipyretic effect;
- antibiotics - to prevent or treat infectious complications;
- antihypertensive drugs - to normalize blood pressure levels.
Alternative methods of treating kidney cysts
On the Internet, you can find many different alternative methods for treating kidney cysts. However, they are all completely ineffective, since they cannot affect the pathogenetic mechanism of tumor formation. In addition, the lack of proper timely treatment increases the risk of developing complications of the disease (suppuration, rupture of the capsule, renal failure) and transformation of a benign cyst into a malignant tumor.
Forecast
The prognosis of the disease is determined by the nature of the neoplasm, its localization, and size. With single-chamber small formations with slow growth, it is favorable. With polycystic and multi-chamber cysts, it worsens, as there is a risk of chronic renal failure and malignancy. However, with timely surgical treatment, the likelihood of such complications is minimal.
Prevention
Specific prophylaxis of renal cysts has not been developed. General recommendations are as follows:
- annual examinations by a urologist of all people over the age of 40;
- blood pressure control;
- timely detection and treatment of diseases of the urinary system.
Video
We offer for viewing a video on the topic of the article.
Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
