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At Cedars-Sinai Marina del Rey Hospital, our experienced nephrologists offer a wide range of diagnostic methods and treatment options for patients suffering from kidney cysts. Our specialists work with patients to choose a personalized treatment plan that best suits the patient’s condition.
The kidneys are a pair of organs located in the back of the upper abdomen, on each side of the spine. Their main function is to filter blood and to remove water-soluble waste, such as urine, which is directed to the bladder. Kidney cysts are described as round, watery, fluid containing pouches, which appear on or inside the kidneys. Most kidney cysts are simple, non-cancerous renal cysts and they generally present no clinical signs or symptoms, nor do they require medical intervention. The main concerns for patients with symptomatic cysts are pain and impaired kidney function, especially when kidney tissues are damaged.
The surgical removal of kidney cysts, also called surgical cyst deroofing or decortication, is generally performed when dealing with cyst recurrence or with large cysts. The most popular technique, when performing this type of surgery, is called laparoscopic deroofing. For this procedure, several 1-2 cm incisions are made for the laparoscopic surgical instruments and for the laparoscopic camera. Drainage (aspiration) of the fluid is performed and the walls of the cyst are cut or burnt (using cauterization). This surgery is done while the patient is under general anesthesia. Additionally, the patient may require one or two days of hospitalization depending on the complexity of the procedure and on the patient’s condition.
The prognosis of simple cysts is excellent and generally, the treatment is effective and with rare complications. Only in extreme cases, when patients suffer serious kidney function impairment, partial or total nephrectomy may be necessary (usually performed via laparoscopic technique). In the rare cases of complex cysts, careful follow-up via computer tomography, magnetic resonance imaging (MRI) or ultrasound can be required to monitor the size and characteristics of the cyst or the presence of solid masses (i.e. a sign of malignancy). Sometimes, in the case of solid masses, a biopsy is required. If malignancy of the cyst is confirmed, then open surgery is performed.
Simple kidney cysts, which show no signs or symptoms and do not impair the kidney function don’t usually require treatment. Routine checks or imaging tests regarding kidney cyst size should be performed periodically. In some of these cases, the cyst resolves by itself.
There are two main types of kidney cysts: simple and complex. Doctors use the Bosniak scoring system to differentiate between simple cysts and complex cysts. Bosniak grade 1 cysts are totally benign (no cancer potential). Apart from these two major types of kidney cysts, there is also a separate type of cystic kidney disease, which is actually a development of multiple cysts found in patients with kidney failure who are treated with dialysis.
Simple kidney cysts usually present no signs or symptoms in most of the cases and rarely cause any complications. However, when talking about larger sized simple cysts, the following symptoms may appear:
When cysts lead to complications (between 2-4% of cases) the following symptoms appear:
In order to efficiently detect kidney cysts and to distinguish between simple ones and complex ones, a series of imaging tests are recommended:
Useful additional tests include:
The causes of simple kidney cysts are not yet clear. One theory explains that when the exterior layer of the kidney weakens, it forms a diverticulum (i.e. a pouch) which becomes filled with fluid and forms a cyst. Blood passes through tiny filters in the kidneys and each filter is connected to a small tube which collects urine. Another theory says that the obstruction of a tubule or a low blood supply for the kidneys could expand the tubule and a cyst would be formed. Nutrition and diet have not been shown to have any impact on the development of kidney cysts. Kidney cysts are often associated with high blood pressure, however, the nature of the relationship between the two is not clear yet (i.e. which one of them might be the cause of the other).
Several natural remedies are cited by various alternative medicine sources for improving kidney function, but their effects have not been analyzed or proven yet, such as:
It is generally thought that the formation of kidney cysts cannot be prevented. However, certain lifestyle modifications can help with improving the kidney’s health and protection, such as:
In the case of confirmed cysts, in order to prevent further problems, one should avoid doing extreme physical activities or any abdominal exercises to avoid rupture.
After treatment, regrowth of the cysts may occur. As a result, your doctor may use sclerosing agents or cauterization in order to prevent that from happening.
Do you suspect you might have kidney cysts? You can always learn more about kidney problems and how to treat them by getting in touch with our highly-skilled specialists at Cedars-Sinai Marina del Rey Hospital.
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