(See also Overview of Cystic Kidney Disease Overview of Cystic Kidney Disease Cystic kidney disease may be congenital or acquired. Congenital disorders may be inherited as autosomal dominant disorders or autosomal recessive disorders or have other causes (eg, sporadic... read more .)
Acquired cysts are usually simple, ie, they are round and sharply demarcated with smooth walls. They may be solitary or multiple.
Solitary renal cysts
Isolated cysts are most often detected incidentally on imaging studies; they are distinguished from other cystic renal disorders and renal masses, such as renal cell carcinoma Renal Cell Carcinoma Renal cell carcinoma (RCC) is the most common renal cancer. Symptoms can include hematuria, flank pain, a palpable mass, and fever of unknown origin (FUO). However, symptoms are often absent... read more , which is typically irregular or multiloculated with complex features such as irregular walls, septae, and areas of unclear demarcation or calcification. Their cause is unknown. They are generally clinically insignificant but rarely can cause hematuria or become infected.
Multiple renal cysts
Multiple cysts are most common in patients with chronic kidney disease Chronic Kidney Disease Chronic kidney disease (CKD) is long-standing, progressive deterioration of renal function. Symptoms develop slowly and in advanced stages include anorexia, nausea, vomiting, stomatitis, dysgeusia... read more , especially patients undergoing dialysis Hemodialysis In hemodialysis, a patient’s blood is pumped into a dialyzer containing 2 fluid compartments configured as bundles of hollow fiber capillary tubes or as parallel, sandwiched sheets of semipermeable... read more for many years. Cause is unknown, but the cysts may be due to compensatory hyperplasia of residually functioning nephrons. More than 50 to 80% of patients receiving dialysis for > 10 years develop acquired cystic disease (with multiple acquired cysts). Usual criterion for diagnosis is ≥ 4 cysts in each kidney detected with ultrasonography or CT. This disorder can usually be differentiated from autosomal dominant polycystic kidney disease Autosomal Dominant Polycystic Kidney Disease (ADPKD) Polycystic kidney disease (PKD) is a hereditary disorder of renal cyst formation causing gradual enlargement of both kidneys, sometimes with progression to renal failure. Almost all forms are... read more by the absence of family history and by small or normal-sized kidneys.
Acquired cysts are usually asymptomatic, but occasional patients develop hematuria, renal or perirenal hemorrhage, infection, or flank pain. Acquired cysts are significant mainly because patients have a higher incidence of renal cell carcinoma Renal Cell Carcinoma Renal cell carcinoma (RCC) is the most common renal cancer. Symptoms can include hematuria, flank pain, a palpable mass, and fever of unknown origin (FUO). However, symptoms are often absent... read more ; whether the cysts become malignant is unknown. For this reason, some physicians periodically screen patients with acquired cysts for renal carcinoma using ultrasonography or CT. Cysts that cause persistent bleeding or infection may require percutaneous drainage or, rarely, partial or complete nephrectomy.