Kidney cysts what are they and how to treat them correctly

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When a person has a cyst on the kidney, he is primarily concerned about how dangerous it is, and whether it can be cured. The cysts themselves are benign formations: they do not metastasize and are not aggressive towards neighboring tissues.

But this does not mean that they are absolutely harmless. When cystic formations reach impressive sizes, and their diagnosis and treatment are delayed, the pathology gives life-threatening complications. It is one of the most insidious kidney diseases.

Description and classification of diseases

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The detection of a cyst on the kidneys occurs most often unexpectedly, since its development begins painlessly and asymptomatically and does not give rise to a visit to a doctor. An ultrasound machine allows you to see what a cyst is on the kidney: a rounded, well-defined formation is visualized on the tissues of the organ.

A cyst is a cavity filled with clear fluid and surrounded by a connective tissue capsule. It sometimes grows to a tumor 10 cm in size, which is comparable to the size of the kidney itself.

Pathology can be congenital and acquired:

  • in the first case, the formation on the kidney of the embryo is formed in the first half of pregnancy under the influence of any unfavorable factors or has a genetic cause; during life it can be safely absorbed. Congenital pathologies account for 5% of cases of this disease,
  • acquired neoplasms on the kidneys are found most often after 40 years, equally often in both men and women. With age, the probability of the disease increases, after 70 years, pathology is found in 75% of the examined patients.

According to the internal structure, a simple and complex form is distinguished:

  • a simple cyst is covered with a spherical capsule made of thin tissue and does not contain internal septa. It occurs most often and almost never degenerates into a malignant tumor,
  • in complex cysts there are internal thickened septa that divide them into segments. The surface of such formations is lumpy and heterogeneous. If they are also entwined with blood vessels, all conditions are created for the malignant transformation of such a cystic focus.

Diseases are also classified according to the nature of the lesion, localization and internal contents of the cavity:

  • parapelvic (sinus) – detected in 2% of elderly patients, mainly in women. It is a single, simple formation located in the pelvis or sinus of the kidney and filled with lymph. Sinus cyst causes urination disorders, provokes an increase in pressure. On the left of this type of pathology is more common than on the right,
  • solitary (solitary) – often found in men, located on the periphery of the right or left kidney. Its capsule is simple, filled with serous fluid, sometimes containing blood or pus. This type of cystic capsule rarely grows to a large size, but it is treated only surgically,
  • multicystosis is a rare congenital pathology (occurs in 1% of infants), more often it develops on one kidney. In this disease, small formations cover the organ almost completely, their contents are liquid, in composition close to blood plasma. The area of ​​tissue sites capable of forming urine is reduced, and the organ practically loses urinary function,
  • polycystic disease is a hereditary disease that can be detected already in adulthood. The parenchyma of both kidneys is affected, it is covered with multiple cystic formations, and a liquid similar to primary urine accumulates inside them. Pathological processes develop simultaneously in other places: in the stomach, liver,
  • parenchymal – located in the parenchyma of the organ, it can be solitary (single) or multiple, both on one and on both kidneys. In its cavity – serous contents, sometimes with blood impurities. Pathology is more often formed in men,
  • dermoid cyst is a rare formation that appears at the stage of development of the embryo, with which children are already born. Its cavity is filled not with liquid, but with another tissue (skin, nails, hair, fat).

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Pathologies are also divided according to the danger they pose to the body:

  • capsules with purulent contents – a source of possible blood poisoning, kidney abscess,
  • dangerously fast growing mass that can accidentally rupture and provoke inflammation of the peritoneum,
  • segmented cysts with a high risk of developing a malignant tumor are of particular concern to doctors and patients.

All formations with such signs must be removed first.

Why does a cyst appear on the kidney

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Scientists and doctors have an idea of ​​the general mechanism by which a kidney cyst is formed, the reasons for starting this process have not yet been fully established.

Formation mechanism

The formation of pathology begins in the renal tubules. Here, the primary urine is concentrated: water with useful substances is absorbed back into the bloodstream, and all unnecessary in the form of final urine is excreted.

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A cyst on the kidney appears in those places where stagnation of primary urine in the tubules occurs, as a result of which they increase in size up to 2 mm.

The immune system reacts to this pathology: the growth of epithelial cells of the dilated tubule begins, it is isolated from the rest of the structures by a connective tissue capsule.

Experts distinguish three groups of factors in the appearance of pathological formations.

Hereditary factor

Hereditary diseases, chromosomal mutations lead to the appearance of cystic formations in the kidneys during the prenatal period. Multicystosis, polycystic disease – some children have such diseases already at birth.

Congenital defects (dermoid, most parenchymal cysts) are not inherited, they are formed in the embryo as a result of an unfavorable course of pregnancy. The most dangerous provoking factors include smoking, alcohol, radiation and solar radiation, poisoning, infections.

Diseases as a provoking factor

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The reasons for the appearance of acquired kidney cysts include various diseases:

  • Kidney tuberculosis, in which the immune system can isolate and localize the site of infection in the form of a cyst.
  • Stagnation of urine with the subsequent formation of a cyst causes the following diseases:
  • pyelonephritis – provokes a disease in women,
  • BPH is a common cause of cystosis in men over 50. The situation is aggravated by hormonal disruption in the man’s body: he has an increase in the amount of female hormones (estrogens), which stimulate the production of epithelium for cystic capsules,
  • urolithiasis disease,
  • glomerulonephritis provokes the development of multicystosis with damage to the right or left kidney,
  • hematomas and other pathologies of the urinary tract.

Hypertension as a systemic disease is capable of creating an ischemic focus in the kidney, followed by the formation of a cyst. People with high blood pressure often have cystic formations on the urinary organs.

Kidney injury

pochka2 - 35Another factor that provokes the onset of cystic formation in the kidney is injury. At the site of the impact, blood circulation is disturbed, followed by stagnation of primary urine in the tubules, its accumulation and the formation of a capsule around it.

Such a mechanism for the development of pathology is quite common, it always gives complications if the injured kidney is not helped in time and its function is not restored.

Clinical signs of the disease

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Symptoms of a kidney cyst appear at the stage when the formation grows to a size of 5-6 cm and begins to press on neighboring tissues, vessels, organs.

It interferes with the normal blood supply, causes blood stasis and inflammation of the kidney tissue. The development of a cyst is accompanied by characteristic signs:

  • lower back pain on one side – where the diseased organ is. Damage to both kidneys is an infrequent phenomenon, so patients’ complaints are reduced to pain on one side of the back. A kidney cyst in women causes sensations similar to symptoms of inflammation of the appendages: during physical work, active movement, lifting weights, as well as in the supine position, pain increases,
  • hypertension is a constant companion of cystic disease, and the lower value of blood pressure increases, which indicates an increased tone of the blood vessels. It is possible to reduce pressure only with the help of ACE inhibitors,
  • macro- and microhematuria – blood in the urine, visible with the naked eye, or the detection of red blood cells under a microscope. This makes urination painful.

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Cystic neoplasms in the later stages become dangerous, therefore it is important to notice the manifestations of pathology in time and start adequate treatment.

What are the threats posed by a cyst on the kidney

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What is the threat of a cystic capsule to the kidney and the whole body?

Large cysts in the kidneys are more dangerous than small ones, since they can rupture with any careless movement, which leads to the development of peritonitis.

Often after the operation, against the background of a general weakening of the body, infections penetrate into the cystic capsule, and pus accumulates there. According to statistics, about 60% of patients die due to peritonitis and blood poisoning with purulent cavity contents.

Also, these formations provoke urinary retention, as a result, hydronephrosis develops with kidney atrophy and chronic renal failure.

One of the dangerous types of complications of a cyst is its transformation into a cancerous tumor.

Diagnostic methods

The appearance of alarming symptoms is a reason to see a doctor. Unaware that he has a cyst on the kidney, and not knowing what it is, a person should contact a therapist. Based on the patient’s complaints, the doctor will prescribe two types of examination.

  • Instrumental diagnostics – education will be detected by ultrasound. This research method is the main one in the diagnosis of renal tissue neoplasms,
  • Laboratory analysis of blood and urine:
  • an increase in blood creatinine and urea and a decrease in functional proteins are a symptom of the development of renal failure,
  • an increase in leukocytes and an accelerated ESR will indicate an inflammatory process in the kidneys, and a low level of erythrocytes – anemia,
  • the presence of protein, leukocytes and erythrocytes in the urine is a sign of a functional disorder of the urinary organs.
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In the early stages of cyst development, all laboratory parameters may be within normal limits, then the therapist will refer the patient to the urologist, based on the ultrasound data. A specialist doctor (urologist, nephrologist) will continue a comprehensive examination:

  • during the collection of anamnesis, he will find out if the disease is hereditary, congenital or acquired,
  • localization, size and type of cystic formation will be clarified,
  • if an oncological process is suspected, a CT scan with a contrast agent is performed. If the computed tomography reveals that the neoplasm has internal partitions, high density, braided with blood vessels, an oncologist’s consultation will be required,
  • a rare and unsafe diagnostic method is the puncture of the cyst and taking its contents to establish the possibility of its degeneration.

The strategy and tactics of treatment will become clear after an accurate diagnosis is made.

Methods for the treatment of cystic formations in the kidney

When the doctor determines what contains and where the kidney cyst is located, treatment will depend on its size.

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Conservative treatment

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With a size less than 5 cm, conservative methods of treating kidney cysts are provided, which means an active-expectant tactic.

Regularly, 1-2 times a year, the patient undergoes an ultrasound scan in order to trace the dynamics of the growth of education. With positive dynamics, the doctor waits for it to grow to the required size in order to conduct a puncture.

Symptomatic therapy is carried out:

  • drugs are prescribed to reduce blood pressure,
  • pain relievers are prescribed
  • the outflow of urine is regulated,
  • treatment of concomitant pathology, which provoked the formation of a cyst, is carried out.

The patient will be transferred to diet food (table number 7), which requires:

  • minimize salt intake,
  • do not get carried away with protein foods,
  • give up alcohol, smoked meats and spices,
  • drink less fluids if there is swelling, shortness of breath, hypertension.

Conservative methods are a means of medical control, but they do not treat cystic formation.

Puncture of the cyst

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When the formation grows to 6 cm in diameter, the doctor can, with the patient’s consent, perform a puncture. Such a procedure is possible provided that the cyst is simple, single, and has no partitions. Using an ultrasound machine, the surgeon finds a place to puncture the cavity with a needle, followed by pumping out the contents.

The walls of the empty neoplasm are cauterized with a chemical solution and an adhesive is injected, which prevents the re-accumulation of liquid in the capsule.

In 70% of cases, the procedure is successful, and there are no recurrences of the cyst. If unsuccessful, there is a risk of kidney infection and inflammation.

Laparoscopy

Kidney surgery to remove the cystic capsule is mandatory for the following indications:

  • the cyst delivers severe pain, presses on adjacent tissues, interferes with the excretion of urine,
  • the cystic capsule may rupture
  • the contents of the cavity are infected,
  • education has degenerated into a malignant tumor.

Surgical intervention, in contrast to puncture, removes the entire formation together with its membrane and all contents. During laparoscopy, an incision in the abdominal cavity is not made: an endoscope is inserted through the punctures to visualize the surgical intervention and two trocars (special surgical instruments).

By manipulating them, remove the capsule and suture the puncture sites. In special cases, when the cyst grows in the parenchyma of the kidney, it is necessary to remove the entire organ. The patient is informed about the possibility of such an outcome of the operation in advance.

Open abdominal surgery is performed when the cyst has already broken through and the patient needs urgent help.

Prevention of complications

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If there is a cyst on the kidneys, it is dangerous to leave it unattended. With congenital pathology, an ultrasound scan should be performed annually to prevent the growth of neoplasms on diseased organs.

With cysts of genetic etiology, there is a high risk of aneurysms, therefore, it is necessary to regularly check the condition of the arteries of the brain. Acquired cysts should be monitored with ultrasound or CT at least once a year. The methods of modern medicine will only help those who look after their own health.

Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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