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Forum Name: Nephrology Symptoms

Question: Large bilateral renal cysts


 KathyJL - Thu Sep 04, 2008 5:54 pm

I am a 55 yr old wht F with recent test results showing 3 renal cysts (9.3 cm in AP and 7.2 cm transversely, right kidney; 9.5 cm cyst lower pole of left kidney; 8.7mm cyst in mid-portion of left kidney. Had test following symptoms of abdominal pain (mild,chronic); significant feelings of bloating; unexplained wt gain; & chronic lower back pain. Labs show BUN of 30 & Creatinine of1.2; EGFR Non-AFR AM of 50: Bun/CREAT Ratio of 25.0; total protein 8.3; Globulin 4.0; ALT (SGPT) 29. All other labs run were within normal range... Cysts were detected with CT exam with oral and IV contrast... Could these cysts be causing extreme fatigue/weakness; bowel elimination problems as well as presenting symptoms previously listed? Could this be Polycystic disease? When is surgery appropriate for renal cysts? I am very responsible with regular checkups with my urologist (due to history of bladder cancer) and with my GP who ordered the tests...Have not spoken to either of them since receiving the test results but am scheduled to see both of them next week. I want to be sure I ask the right questions and am fully informed re. the significance of these results. Can you please address these questions? I have done extensive web research but have not found any protocol for suregery dependent on size or numeber of cysts... Thanks, KJL
 Dr. Safaa Mahmoud - Fri Nov 07, 2008 5:17 pm

User avatar Hello,

Small simple kidney cysts are commonly seen after the age of 50, they rarely result in symptoms and are accidentally discovered.
Large cysts on the other hand may cause complications and present with pain and deterioration of the kidney function thus may require surgical removal.

Having a history of urinary bladder cancer that was recurrent although early stage, the possibility that a mild obstruction in the urine flow out of the kidney was present. Overtime with back pressure on the kidney, renal cysts can be formed.
This could happen if fibrosis has occurred after resection of the mass in the bladder near the ureteric insertion into the bladder.
Another more serious problem to be excluded is the presence of low grade carcinomas in the urinary tract (since bladder cancer is a part of multifocal disease all through the urinary system from the renal pelvis down to the urethra). This may also cause some sort of renal back pressure and cysts formation.

Another possibility is renal stones that may also result in kidney back pressure.

Radiological examination and endoscopy is essential to exclude any lesion throughout the urinary tract. In addition removal of these cysts for diagnosis as well as for therapy may be needed.

This list of possibilities can be narrowed and more specific investigations and approach can be done only after thorough clinical history and clinical examination.
So I advise you to follow up with your Doctor and to discuss with him all your concerns.

Please keep us updated.
Best regards.

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