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Abstract Background Although simple renal cyst (SRC) is a kind of structural alterations of kidney with age, the relationship between SRC and renal function is still obscure. We investigated the relationship between SRC and renal function in Chinese population. Methods The medical records of 41,842 individuals who underwent physical examinations at the Health Check-up Center at our institution in 2018 were reviewed. According to whether with SRC, they were divided into no-SRC and SRC groups. SRCs were classified into subgroups based on number (

Objective: This study was designed to evaluate the feasibility, efficacy, and safety of percutaneous ureteroscopy laser unroofing as an ambulatory surgery for symptomatic simple renal cysts under multilevel paravertebral nerve block anesthesia. Methods: From December 2015 to September 2017, 33 simple renal cyst patients who had surgical indications were enrolled. Under ultrasound guidance, the T10/T11, T11/T12, and T12/L1 paravertebral spaces were identified, and 7–10 mL 0.5% ropivacaine was injected at each segment. Then a puncture needle was placed inside the cyst cavity under ultrasonic monitoring. A guidewire was introduced followed by sequential dilation up to 28/30 Fr. The extra parenchymal portion of the cyst wall was dissociated and incised using a thulium laser, and a pathological examination was performed. Results: Sensory loss to pinprick from T8 to L1 and sensory loss to ice from T6 to L2 were observed in all patients. None of the patients complained of pain during surgery. No serious complications occurred perioperatively. After the surgery, all patients recovered their lower limb muscle strength quickly, got out of bed, resumed oral feeding, and left the hospital within 24 h of admission. The pathologic diagnosis of all cyst walls was a simple renal cyst. The mean follow-up was 35.8 months. At the end of follow-up, the cyst units were reduced in size by more than 50% compared to the preoperative size, and no patient experienced a recurrence. Conclusion: Multi-level paravertebral nerve block for percutaneous ureteroscopy laser unroofing as an ambulatory surgery mode is feasible, safe, and effective for the treatment of simple renal cysts in selected patients.

Purpose: The aim of this study was to investigate the prevalence of simple renal cysts (SRCs) and kidney stone disease (KSD) together with laboratory data in patients with acromegaly through comparisons with healthy subjects, and to examine the possible risk factors associated with these abnormalities in acromegaly. Methods: This retrospective, single-center study included 125 acromegaly patients (46.4 ± 11.6 years, 68 females/57 males) and 114 age-sex matched healthy individuals (45.3 ± 12.4 years, 59 females/55 males). Demographic data, clinical history, biochemical and abdominal/urinary system ultrasonographic data of the patients were reviewed. Results: The SRC prevalence (28.8% vs. 8.8%, p < 0.001) and the longitudinal and transverse lengths of kidneys (p < 0.05) were significantly higher in patients with acromegaly compared to the control group. The presence of acromegaly was determined to increase the risk of SRC formation 12.8-fold. The prevalence of KSD was similar in both the patient and control groups (15.2% vs. 7.9%, p = 0.08). Patients with acromegaly with renal cysts (n = 36) compared to the group without cysts (n = 89) were older, had a higher male gender frequency, a longer pre-diagnosis symptom duration, and a higher incidence of hypertension and diabetes mellitus at the time of diagnosis. The multivariate logistic regression analysis showed that only advanced age and male gender were associated risk factors for SRCs in acromegaly patients. Conclusion: The results of this study showed that acromegaly disease significantly increased the prevalence of SRCs and kidney length compared to the age-sex matched healthy population, while the prevalence of KSD was similar. Advanced age and male gender were seen to be independent risk factors for SRC formation in patients with acromegaly. [ABSTRACT FROM AUTHOR]

Background: Although simple renal cyst (SRC) is a kind of structural alterations of kidney with age, the relationship between SRC and renal function is still obscure. We investigated the relationship between SRC and renal function in Chinese population. Methods: The medical records of 41,842 individuals who underwent physical examinations at the Health Check-up Center at our institution in 2018 were reviewed. According to whether with SRC, they were divided into no-SRC and SRC groups. SRCs were classified into subgroups based on number (< 2 vs. ≥ 2) and size (< 2 cm vs. ≥ 2 cm). Logistic regression was used to examine the relationship between SRC and estimated glomerular filtration rate (eGFR). Results: Multinomial logistic regression analysis showed that the adjusted odds ratio (OR) for eGFR slight decline in subjects with SRC was 1.26(95% confidence interval (95% CI):1.17–1.35, p < 0.001), and the OR for eGFR severe decline was 1.35(95% CI: 1.16–1.56, p < 0.001) compared with no-SRC. The adjusted OR of SRC number ≥ 2 and ≥ 2 cm on the risk of eGFR severe decline was the highest (OR:1.68, 95% CI:1.25–2.23, p < 0.01) of four SRC subgroups. Conclusions: SRC is related to eGFR decline, especially when the person with one more SRCs and the size of SRC is more than 2 cm. SRC could be a warning sign for clinicians to judge the decline of renal function. [ABSTRACT FROM AUTHOR]

An increased prevalence of thoracic aortic aneurysms (TAA) has been demonstrated in patients with simple renal cysts (SRC); patients with SRC have a less elastic aortic wall than those without SRC. The purpose of this study was to evaluate aneurysm sac shrinkage after thoracic endovascular aortic repair (TEVAR) for true TAA in patients with and without SRC. One hundred three patients with true aneurysms of the thoracic aorta who underwent TEVAR at our university hospital from November 2013 to December 2021 were included in this study. Aneurysm sac size was compared between that on baseline preoperative computed tomography and that on postoperative computed tomography scans at 1 year. A change in aneurysm sac size ≥5 mm was considered to be significant, whether due to expansion or shrinkage. The patients were divided into two groups: those with SRC (46 patients [45%]) and those without SRC (57 patients [55%]). At 1 year, there was a significant difference in the proportion of aneurysm sac shrinkage between patients with SRC and those without SRC (23.9% vs 59.6%; P <.001). Patients with SRC showed significantly less aneurysm sac shrinkage than those without SRC (−1.8 ± 5.6 mm vs −5.1 ± 6.6 mm; P =.009). Univariable and multivariable analyses showed that the initial sac diameter (odds ratio, 1.08; 95% confidence interval, 1.03-1.14; P =.002) and the presence of SRC (odds ratio, 0.15; 95% confidence interval, 0.06-0.40; P <.001) were positively and negatively associated with aneurysm sac shrinkage after TEVAR, respectively. The presence of a SRC was independently associated with failure of aneurysm sac shrinkage after TEVAR for true TAA. This suggests that the presence of a SRC may be a predictor for the failure of aneurysm sac shrinkage after TEVAR. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Simple renal cysts are lesions that are epithelial in origin, with a prevalence changing between 5 to 15% in the normal population. In animal studies, it was shown that PTH might stimulate cyst formation via intracellular signaling systems triggering epithelial cell proliferation. Our primary aim was to detect the simple cyst prevalence in a large cohort of PHPT and compare it with sex and age-matched health individuals. The secondary aim was to detect determinants of cyst formation in PHPT. METHODS: A total of 307 PHPT patients and 112 healthy controls were enrolled in our study. PHPT group was compared with the control group regarding the biochemical parameters and presence, size and bilaterality of renal cysts in the US performed by a single experienced radiologist. RESULTS: Prevalence (43.65% vs 25%, p=0.020) and size [28.40 mm (min-max: 4-82) vs 12.20 mm (min-max: 3-94) (p=0.013)] of simple renal cysts were higher in the PHPT group compared to controls. The presence of renal cysts was correlated with age but not sex and positively correlated with the serum PTH level in regression analysis. Serum Ca, P, and 24-hour urinary Ca excretion were not found to be associated with cyst formation. DISCUSSION AND CONCLUSION: Simple renal cysts are a benign renal complication of PHPT that does not alter renal function significantly, and their presence is directly correlated with the hypersecretion of PTH.

Abstract A simple renal cyst (SRC) may increase the risk for hypertension. The authors examined the relationship between a SRC and hypertension in participants receiving physical examinations at Hebei Medical University. This study enrolled 66 883 participants who received physical examinations at our center from January 2012 to December 2017. Demographic data, medical history related to hypertension, hematological indexes, hypertension, and SRC subtype based on ultrasound examinations were examined. The relationship between SRC and hypertension was analyzed using univariate and multivariate logistic regression analysis in different models. Subgroup analysis and propensity score (PS) matching were also performed. Based on SRC subtype (unitary vs. multiple, small vs. large, unilateral vs. bilateral), a comprehensive scoring system was established to determine the effect of SRC load on hypertension. The results of univariate and multivariate analysis indicated that SRC was a risk factor for hypertension (P .05). A SRC remained an independent risk factor for hypertension after PS matching (P

Simple renal cysts (SRC) are associated with the development of abdominal aortic aneurysms (AAA). We hypothesized that patients with AAA and SRC have increased arterial stiffness (AS) compared with patients without SRC. Patients (n=223) with an infrarenal AAA undergoing pulse wave analysis were recruited. Brachial-ankle pulse wave velocity (PWV) was measured (automated oscillometric method) as an index of AS. Participants were categorized into those with increased AS and those with normal/borderline AS (threshold: 1800 cm/s); 134 patients (60.1%) had increased AS and 89 (39.9%) patients had normal/borderline AS. Multivariable analyses showed that age ≥75 years (odds ratio [OR], 2.83; 95% confidence interval [CI], 1.51–5.72; P =.002), systolic blood pressure ≥140 mmHg (OR, 5.05; 95% CI, 2.35–10.83; P <.001), hypertension (OR, 2.28; 95% CI, 1.08–4.79; P =.030), and presence of SRC (OR, 1.89; 95% CI, 1.03–3.46; P =.040) were independent risk factors for increased AS. The presence of SRC is an independent risk factor for increased AS in patients with an AAA. This association suggests that patients with SRC may have severe aortic wall degeneration and thus the presence of SRC may be pathologically linked to the development of AAA. [ABSTRACT FROM AUTHOR]

A simple renal cyst (SRC) may increase the risk for hypertension. The authors examined the relationship between a SRC and hypertension in participants receiving physical examinations at Hebei Medical University. This study enrolled 66 883 participants who received physical examinations at our center from January 2012 to December 2017. Demographic data, medical history related to hypertension, hematological indexes, hypertension, and SRC subtype based on ultrasound examinations were examined. The relationship between SRC and hypertension was analyzed using univariate and multivariate logistic regression analysis in different models. Subgroup analysis and propensity score (PS) matching were also performed. Based on SRC subtype (unitary vs. multiple, small vs. large, unilateral vs. bilateral), a comprehensive scoring system was established to determine the effect of SRC load on hypertension. The results of univariate and multivariate analysis indicated that SRC was a risk factor for hypertension (P <.01). Subgroup and interaction analysis showed the homogeneity that SRC was an independent risk factor for hypertension in multiple subgroups (P >.05). A SRC remained an independent risk factor for hypertension after PS matching (P <.01). Based on a scoring system that considered different SRC subtypes, the risk for hypertension increased with renal cyst load (P <.01). In conclusions, a SRC was an independent risk factor for hypertension, and there was a positive correlation between SRC load and hypertension. The risk of hypertension increased gradually with the size, number, and location of a SRC. Careful follow‐up or excision should be considered for patients with SRCs. [ABSTRACT FROM AUTHOR]

Simple renal cysts are commonly acquired benign lesions of the kidney. Requiring management only when it causes pain, obstruction, or gross hematuria, endoscopic marsupialization of simple renal cysts is a new method for the management of renal cysts. Herein, we present a rare case of a 44-year-old female with a simple renal cyst that was managed for the first time in Saudi Arabia by endoscopic marsupialization and discuss its efficacy and outcome compared to other methods of management., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Bin Hamri et al.)

Background: People with simple renal cysts (SRCs) are more likely to develop renal injury and dysfunction, but the mechanisms remain controversial, as the process of SRC formation and its characteristics are not yet well-known. This research focuses on the characteristics of SRCs and discusses how SRCs cause renal injury. Methods: In 2014, a total of 401 participants without any prior kidney disease were selected for the research. Their average age was 49.7 years. SRC morphology and changes were monitored over a 5-year follow-up period. Renal volume and blood perfusion were measured by ultrasound imaging. Logistic regression analysis was used to assess the relationship between renal cyst and renal function. Results: During the 5-year follow-up, elderly participants with multiple cysts (odds ratio [OR] 1.89; 95% CI 1.67 to 5.99) and a maximum cyst diameter of 1.5 cm or greater (OR 1.93; 95% CI 1.15 to 5.34) were found to be positively correlated with renal injury. A decrease in intrarenal perfusion was observed at the early stages of follow-up, but the reduction in renal volume was a slow and gradual process. Conclusion: Elderly people with multiple cysts, a maximum cyst diameter of the cysts ≥ 1.5 cm, and multiple cysts are more likely to suffer renal injury. Ultrasound examination has an important status in monitoring the changes in renal volume and peak systolic velocity (PSV) of the renal interlobar artery. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy and safety of percutaneous polidocanol sclerotherapy and laparoscopic deroofing in the management of pediatric symptomatic simple renal cysts (SRCs). Methods: Forty-six patients with symptomatic SRCs (cyst size ≥4 cm) were treated either with polidocanol sclerotherapy (group A) or by laparoscopic deroofing (group B) between December 2009 and October 2019. The patients were reevaluated at 1, 6, and 12 months and annually thereafter. Results: Twenty-one patients were treated with polidocanol sclerotherapy (group A) and 25 patients with laparoscopic deroofing (group B). The mean follow-up period was 58.7 months (14–107) in group A and 57.2 months (12–118) in group B. Complete regression was seen in 19 (90.5%) and 24 (96%) patients in groups A and B, respectively (p < 0.05). Partial regression was documented in one patient each in group A (4.8%) and B (4%). In one group A patient, a laparoscopic deroofing was performed due to sclerotherapy failure after 27 months. The operation time, postoperative hospital stay, and cost were significantly less in group A than in group B (36.3 ± 8.4 vs 96.9 ± 19.1, 19.7 ± 2.4 vs 56.0 ± 8.6, and ¥8173 ± 1343 vs ¥14,119 ± 2021, respectively; p < 0.05). Conclusion: Polidocanol sclerotherapy and laparoscopic deroofing were found to be equally effective interventions associated with minimal complications for pediatric symptomatic SRCs. We recommend polidocanol sclerotherapy as the first option for children with symptomatic SRCs and laparoscopic deroofing in cases of failed polidocanol sclerotherapy. [ABSTRACT FROM AUTHOR]

A radiographic incidental finding (sometimes called an incidentaloma) is defined as a structure that is unintentionally found during an exam for an unrelated indication. The increased use of routine abdominal imaging is associated with a rising incidence in incidentalomas of the kidney [1]. In one meta-analysis, 75% of renal incidentalomas were benign [2]. However, the overall prevalence of incidental carcinomas is low at 0.2% [3]. With the growing uptake of POCUS, healthy volunteers for clinical demonstrations may find themselves with new findings despite a lack of symptoms [4]. Having an incidentaloma discovered during the course of a nephrology POCUS workshop is a unique experience. Herein we report our experiences of having incidentalomas discovered during the course of POCUS demonstrations.

Calyceal diverticula and epidermal cysts are extremely rare kidney lesions with unknown etiology and pathogenesis. They have non-specific clinical and radiological picture. Despite the benign nature, sometimes these disorders mimic malignant tumors leading to unjustified nephrectomy. We present a clinical and morphological observation of a multicystic lesion in a 76-year-old patient's right kidney filled with keratinized masses and imitating a malignant solid tumor. The detailed gross, histological and immunohistochemical (desmin, cytokeratin 7, uroplakin and p63) analyses of the kidney tissue excluded the malignant nature of the lesion. The final differential diagnosis was between an epidermal cyst and calyceal diverticulum with pronounced squamous cell metaplasia of urothelium. The upper pole localization of the lesion, its connection with the pelvicalyceal system through the unobstructed isthmus, the presence of urothelial lining and smooth muscle cells in its wall let us diagnose a calyceal diverticulum type I. Knowledge of the key clinical and morphological features of epidermal cysts and diverticula of the pelvicalyceal system will help the practicing physicians suspect the benign nature of such lesions and perform organ-preserving operations.

Background: The presence of simple renal cyst (SRC) has been associated to renal dysfunction, but the results were inconsistent. Accordingly, we conducted a longitudinal cohort study to explore the association between SRC and kidney damage. Methods: A total of 4274 adults (aged 45.4 ± 13.6 years) without chronic kidney disease at baseline were enrolled in 2008. SRC was assessed by ultrasonography. Logistic regression analysis were applied to explore the relationships between SRC and indicators of kidney damage (proteinuria and renal insufficiency), and also with relatively rapid decline in renal function (defined as the lowest quartile of △eGFR). Results: During 5 years of follow-up, participants in the SRC group had higher incidence of proteinuria (5.2% versus 2.4%, p = 0.004) and renal insufficiency (3.8% versus 0.97%, p

Amaç: Basit böbrek kistleri, erişkinlerde en sık görülen kistik oluşumlardır. Basit böbrek kistleri ve hipertansiyon gelişimi arasındaki ilişki halen tartışmalıdır. Bu çalışmada mikroskobik hematürili hastalarda basit böbrek kistleri ve hipertansiyon sıklığı arasındaki ilişkinin incelenmesi amaçlanmıştır.Gereç ve Yöntemler: Mikroskopik hematüri sebebiyle tüm batın ultrason ve tüm batın bilgisayarlı tomografi uygulanmış 1075 hastadan yaşları 51 ile 89 arasında olan 200 hastanın geriye dönük bulgularının incelenmesi ile iki grup oluşturularak çalışma dizayn edildi. Hastalar böbrek kisti olan ve böbrek kisti olmayan hastalar şeklinde iki gruba ayrılarak değerlendirildi. Basit böbrek kisti ve hipertansiyon arasındaki ilişki incelendi.Bulgular: İki grup arasında yaş ve cinsiyet gibi demografik özellikler açısından anlamlı bir farklılık saptanmadı. Basit böbrek kisti olan grupla kontrol grubu arasında hipertansiyon görülme oranları açısından anlamlı bir farklılık izlenmedi (p=0,471). Basit böbrek kisti olan hastalarda yaşın yanında, kist boyutu, çoklu kist varlığı, birden fazla bölgede kist bulunması ve bilateral kist olmasının hipertansiyon varlığını artırdığı saptandı (tüm p değerleri

Objective: This study was designed to evaluate the feasibility, efficacy, and safety of percutaneous ureteroscopy laser unroofing as an ambulatory surgery for symptomatic simple renal cysts under multilevel paravertebral nerve block anesthesia., Methods: From December 2015 to September 2017, 33 simple renal cyst patients who had surgical indications were enrolled. Under ultrasound guidance, the T10/T11, T11/T12, and T12/L1 paravertebral spaces were identified, and 7-10 mL 0.5% ropivacaine was injected at each segment. Then a puncture needle was placed inside the cyst cavity under ultrasonic monitoring. A guidewire was introduced followed by sequential dilation up to 28/30 Fr. The extra parenchymal portion of the cyst wall was dissociated and incised using a thulium laser, and a pathological examination was performed., Results: Sensory loss to pinprick from T8 to L1 and sensory loss to ice from T6 to L2 were observed in all patients. None of the patients complained of pain during surgery. No serious complications occurred perioperatively. After the surgery, all patients recovered their lower limb muscle strength quickly, got out of bed, resumed oral feeding, and left the hospital within 24 h of admission. The pathologic diagnosis of all cyst walls was a simple renal cyst. The mean follow-up was 35.8 months. At the end of follow-up, the cyst units were reduced in size by more than 50% compared to the preoperative size, and no patient experienced a recurrence., Conclusion: Multi-level paravertebral nerve block for percutaneous ureteroscopy laser unroofing as an ambulatory surgery mode is feasible, safe, and effective for the treatment of simple renal cysts in selected patients., (© 2024 Editorial Office of Asian Journal of Urology. Production and hosting by Elsevier B.V.)

Objective: The objective of this meta‐analysis of observational studies was to evaluate the association between simple renal cysts (SRC) and presence of aortic pathology such as aortic aneurysms and dissection. Methods: We conducted searches in Ovid MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials from January 1960 to August 2019 to identify observational studies that examined the association between SRCs and any aortic diseases, including aortic aneurysms and dissection. Two reviewers independently extracted the data and assessed the risk of bias. The meta‐analysis was performed by STATA 14.1. Results: In total, 11 observational studies with 19 719 participants were included in this meta‐analysis. Compared to individuals without SRCs, patients with SRCs had higher odds of abdominal aortic aneurysm (AAA) (adjusted OR = 2.61, 95% CI 2.34‐2.91, P < 0.001, I2 = 0%), ascending thoracic aortic aneurysm (TAA) (adjusted OR = 1.98, 95% CI 1.09‐3.63, P = 0.03, I2 = 90.1%), descending TAA (adjusted OR = 3.44, 95% CI, 2.67‐4.43, P < 0.001, I2 = 0%), type A aortic dissection (AD) (adjusted OR = 1.98, 95% CI 1.32‐2.96, P = 0.001, I2 = 12.9%), and type B AD (adjusted OR = 2.55, 95% CI, 1.31‐4.96, P = 0.006, I2 = 76.2%). There was a higher average in the sum of diameter of SRCs among AAA compared to patients without AAA (WMD = 19.80 mm, 95% CI 13.92‐25.67, P < 0.001, I2 = 63.8%). Conclusion: SRC is associated with higher odds of aortic diseases including AAA, ascending and descending TAA, type A and type B dissection even after adjusting for confounders. [ABSTRACT FROM AUTHOR]

A 53-year-old female was referred for evaluation of a small right renal mass. She had an oncological history of adenocarcinoma of the cervix in 2015. Upon review of her imaging, her right posterior lower-pole lesion demonstrated malignant transformation from a 2.7-cm simple cyst in 2016, to development of a complex cyst with internal vascularity, and ultimately a 1.6 cm, right, lower-pole, exophytic, enhancing, posteriorly located solid renal mass concerning for renal cell carcinoma. The patient opted for surgical removal and underwent a right robotic-assisted laparoscopic partial nephrectomy. Pathology was consistent with a T1a clear cell renal cell carcinoma.

Hydatid cyst is commonly involve the liver and lung, but involvement of the kidney is very rare. We present a case of a young female presented to our institute with right abdominal mass, diagnosed as query liver hydated cyst with right renal simple cyst. Unfortunately, during deroofing of the simple renal cyst, there was a spillage inside the abdomen, hydated cyst was suspected and underwent removal of liver and kidney cysts. We are reporting this case due to its rarity and to highlight the importance of detailed history and further investigations in such cases presenting with simple renal cyst.

We encountered 2 patients with symptomatic huge simple renal cysts. In case 1, 4,000 mL of cyst fluid was drained via a catheter, but intracystic bleeding occurred immediately afterwards. Transcatheter arterial embolization (TAE) was performed, after which the bleeding stopped, and cyst drainage was repeated successfully. After 2 years, the total cyst volume was reduced from 11,775 mL to 75.4 mL. In case 2, TAE was performed prophylactically before drainage. Subsequently, 9,400 mL of fluid was removed from multiple cysts. After 1 year, the total cyst volume was reduced from 9,215 mL to 633 mL without bleeding. Based on these 2 cases, prophylactic TAE before drainage may be useful in patients with huge renal cysts.

Background: Percutaneous aspiration with sclerotherapy (PAS) and laparoscopic marsupialization (LM) are minimally invasive treatment modalities for renal cysts. We aimed to compare the efficacy and cost/effectiveness of LM and PAS for the treatment of simple symptomatic renal cysts. Methods: Data were prospectively collected from three health care institutions in which 80 patients with symptomatic simple renal cysts underwent a single session of PAS with 95% ethanol (PAS group, n = 40) or underwent LM under general anesthesia (LM group, n = 40) between March 2012 and May 2016. We compared the patient profile, duration of procedure, duration of hospital stay, radiological and symptomatic success rates, treatment costs, and incidence of complications between the two groups. Results: At the 6-month follow-up, the radiological success rate in the LM group was significantly greater than that in the PAS group (97.5% versus 60%; P < .001). The symptomatic success rate was comparable in the two groups (95% versus 90%; P = .675). The treatment failure rate did not significantly differ between the two groups (5.0% versus 17.5%, P = .154). The mean total cost in the PAS and LM groups was 1256 USD and 2343 USD, respectively (P = .001). No significant between-group difference was noted regarding the overall complication rate (P = .615). Conclusions: Both LM and PAS are effective and safe procedures for the treatment of symptomatic simple renal cysts. A single session of PAS seems to be a cost-effective method for the management of symptomatic simple renal cysts. [ABSTRACT FROM AUTHOR]

Objective: Large solitary renal cysts (SRC) may result in renal ischemia. Renalase, a protective enzyme against ischemic renal injury, has an effective role in controlling blood pressure (BP). Therefore, we aimed to investigate the relationships among pre- and postoperative serum angiotensinogen, epinephrine, renalase/epinephrine ratio, and BP in patients who underwent laparoscopic cyst decortication. Materials and Methods: We included 20 patients with large SRC and 16 healthy individuals in this prospective study. Cysts were diagnosed by ultrasonography and characterized using computed tomography. Blood and urine samples were collected during pre- and postoperative periods. In addition, 12-hour ambulatory BP values were recorded. Serum angiotensinogen, renalase, and epinephrine levels were measured by the enzyme-linked immunosorbent assay method. Results: There was no statistically significant difference in angiotensinogen and renalase levels between patient and control groups (p=0.205, p=0.163, respectively), but preoperative renalase/epinephrine ratio was significantly higher in patients (p=0.006) than in the control group. In addition, renalase/epinephrine ratio was significantly lower in the postoperative period (p=0.018). Univariate and multivariate logistic regression analyses demonstrated that a higher renalase/ epinephrine ratio was associated with the presence of SRC (p=0.028, p=0.016, respectively). Conclusion: A high renalase/epinephrine ratio may be associated with the presence of large SRC. We think that renalase may be a biomarker in the management of SRC and decision making in surgical procedures. Association of renalase with large SRC should be explored in future studies. [ABSTRACT FROM AUTHOR]

Background: The presence of simple renal cyst (SRC) has been associated to renal dysfunction, but the results were inconsistent. Accordingly, we conducted a longitudinal cohort study to explore the association between SRC and kidney damage. Methods: A total of 4274 adults (aged 45.4 ± 13.6 years) without chronic kidney disease at baseline were enrolled in 2008. SRC was assessed by ultrasonography. Logistic regression analysis were applied to explore the relationships between SRC and indicators of kidney damage (proteinuria and renal insufficiency), and also with relatively rapid decline in renal function (defined as the lowest quartile of △eGFR). Results: During 5 years of follow-up, participants in the SRC group had higher incidence of proteinuria (5.2% versus 2.4%, p = 0.004) and renal insufficiency (3.8% versus 0.97%, p < 0.001) compared with control group. SRC was correlated with proteinuria (OR 2.24; 95% CI 1.34–3.75) and renal insufficiency (OR 4.0; 95% CI 2.11–7.58) in univariable analysis, despite that the correlation was not significant after adjusted for traditional kidney disease risk factors. Furthermore, after adjusted for potential confounders, maximum diameter of the cyst (≥2.2 cm) was significantly associated with rapid decline in renal function (OR 2.19; 95% CI 1.24–3.87). Conclusions: Participants with SRC may be associated with higher incidence of proteinuria and renal insufficiency. This relationship may be obscured by age and other traditional risk factors. Higher diameter of the cysts contributed to more rapid decline in renal function of SRC participants. [ABSTRACT FROM AUTHOR]

Kidney is one of the most common sites for the cyst formation in the body, and the management of simple cysts is required entirely for its symptoms and complications. Surgical decortication is an established treatment for a large and symptomatic simple renal cyst. On the other hand, hydatid cysts of the kidney are usually multiloculated complex or calcified cysts and are quite rare.[2]Their surgical treatment also differs and requires complete excision with pericystectomy or partial/complete nephrectomy depending upon residual functional parenchyma, using extreme caution to avoid spillage, recurrence or development of severe anaphylactic shock.[3]A simple cyst harboring a hydatid cyst is highly uncommon and quite dangerous; as if not diagnosed preoperatively, it can create huge trouble for both the patient and the operating surgeon which happened in the present case.

Introduction: The objectives of this study were to evaluate the safety and efficacy of aspiration with percutaneous nephrostomy tube and sclerotherapy with 96% ethanol for a simple renal cyst.Methods: Between 2011 and 2014, 34 patients with symptomatic renal cysts were included in the study. The mean age was 52.3±4.6 years (range, 39–72 years). The patients had only flank pain. The procedure was performed with ultrasound guidance and under fluoroscopic control. After the puncture using an 18-G angiography needle, the guidewire was advanced to the collecting system. A 14-Fr nephrostomy catheter was then advanced over the guidewire. After cystography, 96% ethanol was injected into the cyst and drained amount 10%. We continued to daily inject the same amount of ethanol postoperatively until the drainage was

The constant expansion of treatment methods' range of cysts of kidneys - from the puncture to video and endoscopic resections - became a motivation to further improvement of low-invasive surgical techniques. The article presents the method of endovideotechnology treatment of solitary renal cysts. A laparoscopic resection of renal cysts with the treatment of the remaining lining of argon-plasma coagulation was performed in 32 children aged from 3 months to 17 years. Three trocars were used during the main stages of operation; they were set up depending on cyst's location. The sizes of cysts varied from 3 to 11 cm. Sometimes the fourth trocar was used for the retraction of liver and spleen and for the overviewing the remaining part of the cyst situated on the superior posterior part of kidneys. The operation lastedfor about26.6 ± 2.3 minutes in average, there weren't any conversions and intraoperative complications. One 7-years-old patient had a complication in the early postoperative period: disruption of the calyx. The article focuses on the features of operational equipment depending on the location of cysts in kidneys. The transperitoneal resection of prime renal cysts with an ablation of the internal wall of a cyst with argon-plasma coagulation gives high percent of effectiveness, rapid rehabilitation of children, excellentfunctional and cosmetic result and allows to avoid a disease recurrence.

Introduction: Renal cysts are a common disease that occurs at a rate of 7-10%. Currently there are no clinical recommendations for the treatment of patients with simple renal cysts. In the current literature there is some evidence that a simple renal cyst has negative effects on renal function. Decreased renal function occurs due to partial atrophy and loss of the renal parenchyma (in the "crater" area at the base of the cyst) caused by compression. Therefore, the efforts to analyze the effect of simple kidney cysts on kidney function and identify the characteristics of the cyst that affect renal function to determine the indications for surgical treatment remains a substantial task. The aim of the study was to analyze the effect of simple renal cysts on renal function, to investigate the relationship between cyst size, atrophied parenchyma volume, and renal function, and to determine indications for surgical treatment of simple renal cysts., Materials and Methods: We conducted a prospective cohort study. The study included 109 patients with simple renal cysts. Patients with a solitary cyst of the right or left renal kidney, grade I-II according to Bosniak classification, were included in the study. The estimated glomerular filtration rate (eGFR) of the patients was calculated using various formulas. A contrast CT scan of the urinary tract was also performed to determine the maximum size of the cyst, calculate the volume of the renal parenchyma, and the volume of the lost (atrophied) parenchyma. Patients underwent renal scintigraphy with calculation of total GFR and split renal function. We analyzed the symmetry of the function of both kidneys by comparing the GFR of the affected and healthy kidneys, analyzed the relationship between the presence of a kidney cyst and a decrease in GFR, between the maximum size of a renal cyst and a decrease in its function compared with that of a healthy kidney. We also analyzed the correspondence of total GFR values obtained in renal scintigraphy and GFR values calculated according to the formulas., Results: Data from 109 patients were available for analysis; the mean blood creatinine was 87.4 mol/L. The median maximum cyst size was 80 mm. The median baseline volume of the affected kidney parenchyma was 174 ml, the median volume of the lost parenchyma was 49 ml, and the median proportion of the lost parenchyma was 28%. The median total GFR was 77.07 ml/min. The median GFR of the healthy kidney was 45.49 mL/min, and the median GFR of the kidney affected by the cyst was 34.46 mL/min. The median difference in GFR of the healthy and affected kidney units was 11 mL/min and was statistically significant. Comparison of the eGFR values obtained by the formulas with the reference values of GFR obtained by scintigraphy showed that the Cockcroft-Gault formula with standardization on the body surface area calculated closest eGFR values to the reference ones. Correlation analysis revealed a statistically significant association between the proportion of lost parenchyma volume and the maximum cyst size: =0.37 with 95% CI [0.20; 0.52] (p-value = 0). A multivariate logistic regression model revealed that a statistically significant factor influencing the probability of a significant decrease in GFR was the percent of lost renal parenchyma volume (OR=1,13; =0)., Conclusions: Our study showed that growth of renal cysts associated with renal parenchyma atrophy and decrease of GFR of the affected kidney. An increase in the volume of atrophied parenchyma leads to the decrease in GFR of the affected kidney. The obtained data suggest that performing dynamic renal scintigraphy to assess the decrease in affected renal function and determine the indications for surgical treatment of renal cysts is a reasonable recommendation. According to the results of the study, the loss of 20% of the renal parenchyma can be considered an indication for renal scintigraphy. The Cockcroft-Gault formula with standardization on the body surface area allows to calculate closest GFR values to those obtained by scintigraphy and, therefore, can be recommended as the optimal formula for calculating eGFR in daily clinical practice.

Aim: Simple renal cyst is the most common cystic formation in adults. The relationship between simple renal cyst and hypertension incidence is still controversial. In this study it is aimed to determine any association between simple renal cyst and frequency of hypertension in patients with microscopic hematuria. Material and Methods: The study was designed by reviewing results of 200 patients with ages between 51 and 89 retrospectively and creating two groups, among 1075 patients who had undergone abdominal ultrasonography and abdominal computer tomography due to microscopic hematuria. The patients were evaluated into two groups regarding presence of simple renal cyst or not. The relationship between simple renal cyst and hypertension was analyzed. Results: There is no significant difference between two groups according to demographic features such as age and gender. Hypertension rate was not differ significantly between the simple renal cyst group and control group (p=0.471). It was detected that cyst size, presence of multiple cysts, cysts at more than one location and bilateral cysts were increased the hypertension rate in addition to age in patients with simple renal cyst (all p values <0.001). Cut-off level of cyst size for hypertension diagnosis was determined as ≥2 cm (AUC=0.949, 95% GA=0.903-0.995, p<0.001). Conclusion: As a result, we found a significant association between frequency of hypertension and presence of 2 cm and greater simple renal cysts, presence of multiple cysts and presence of bilateral cysts. Further prospective researches are required to determine the reason and the necessary management. [ABSTRACT FROM AUTHOR]

Background: The presence of simple renal cyst (SRC) has been related to hypertension, the early and long-term allograft function, and aortic disease, but the relationship with kidney damage was still controversial. Accordingly, we conducted a large sample cross-sectional study to explore the association of SRC with indicators of kidney damage among Chinese adults.Methods: A total of 42,369 adults (aged 45.8 ± 13.67 years, 70.6% males) who visited the Health Checkup Clinic were consecutively enrolled. SRC was assessed by ultrasonography according to Bosniak category. Multiple regression models were applied to explore the relationships between SRC and indicators of kidney damage [proteinuria (dipstick urine protein ≥ 1+) and decreased estimated glomerular filtration rate (DeGFR) < 60 ml/min/1.73 m2].Results: Among all participants in the study, the prevalence of SRC was 10.5%. As a categorical outcome, participants with more 1 cyst and with 1 cyst had higher percentage of proteinuria [53 (5.3%) and 93 (2.7%) vs. 596 (1.6%), p < 0.001] and DeGFR [57 (5.7%) and 85 (2.5%) vs. 278 (0.7%), p < 0.001] compared with participants with no cyst. SRC significantly correlated with proteinuria [OR 1.59 (95% CI 1.30-1.95)] and DeGFR [OR 1.97 (95% CI 1.56-2.47)] after adjusting for potential confounders. Furthermore, the results also demonstrated that maximum diameter (per 1 cm increase), bilateral location, and multiple cysts significantly correlated with DeGFR in the multiple logistic regression analysis.Conclusions: The study revealed that SRC significantly correlated with kidney damage and special attention should be paid among Chinese adults with SRC. [ABSTRACT FROM AUTHOR]

Renal cysts are being increasingly diagnosed in children due to the increasing use of ultrasound scanning (USS). Most are asymptomatic, but they may present with flank pain, haematuria, palpable mass or even urinary tract infections or urosepsis. There is a wide range of management options for symptomatic cysts, the choice of which depends on patient factors as well as surgeons' preference. In this case series, we present our experience in the management of five cases of symptomatic renal cysts which have been treated in varying ways, ranging from minimally invasive procedures to drain and sclerose the cysts, to more invasive procedures to excise and deroof the cysts. [ABSTRACT FROM AUTHOR]

Kidney is one of the most common sites for the cyst formation in the body, and the management of simple cysts is required entirely for its symptoms and complications. Surgical decortication is an established treatment for a large and symptomatic simple renal cyst. On the other hand, hydatid cysts of the kidney are usually multiloculated complex or calcified cysts and are quite rare. Their surgical treatment also differs and requires complete excision with pericystectomy or partial/complete nephrectomy depending upon residual functional parenchyma, using extreme caution to avoid spillage, recurrence or development of severe anaphylactic shock. A simple cyst harboring a hydatid cyst is highly uncommon and quite dangerous; as if not diagnosed preoperatively, it can create huge trouble for both the patient and the operating surgeon which happened in the present case. [ABSTRACT FROM AUTHOR]