System Imaging in Unexplained Fever
Benedict Isaac, Serge Kernbaum, Michael Burke in Unexplained Fever, 2019
As in most imaging modalities, ultrasound is unable to provide a tissue-specific diagnosis. However, renal sonography is particularly well suited in determining the characterization of renal masses. Lesions in excess of 2 cm in diameter will usually be detected by their sonographic appearance in the kidney.26 Ultrasonography is able to detect simple renal cysts more accurately.27 Less commonly, an abscess will be indistinguishable from a simple cyst on ultrasonography.28 Other cystic lesions of the kidney, detectable by ultrasonography as a cause of fever, include cystic and necrotic tumors, pyonephrosis, abscesses, tuberculous cavities, and infected cysts. Needle aspiration aided by organismal or cytological identification is usually required to finalize the diagnosis. Renal cell carcinoma, apart from being a solid lesion, may develop a cystic component by virtue of extensive necrosis, or develop in the wall of a pre-existing renal cyst. Solid renal masses that may masquerade as possible malignancies include metastases, acute focal bacterial nephritis, lymphoma, sarcoma, and focal xanthogranulomatous inflammation.29 Ultrasonography is a mandatory investigation for the detection of renal pathology as a cause of fever.
Test Paper 1
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike in Get Through, 2017
A contrast CT scan shows an incidental renal cyst that is hyperdense with thick septations and a mural nodule. What is the Bosniak classification? Type 1Type 2Type 2FType 3Type 4
Conditions
Sarah Bekaert in Women's Health, 2018
Kidney cyst – a round swelling in the kidney, with a very thin, clear wall, and usually filled with watery fluid. The kidney is composed of blood vessels which carry blood to tiny filters. Each filter is connected to a tube. There are about a million filter-and-tube units in each kidney. A cyst occurs when a single tube expands, often becoming quite large. The exact cause of the swelling of the tube is not known. Some cysts are normal, but there is a possibility that they can interfere with kidney function.
The safety and efficacy of laparoscopic microwave ablation-assisted partial nephrectomy: a new avenue for the treatment of cystic renal tumors
Published in International Journal of Hyperthermia, 2023
Baoan Hong, Qiang Zhao, Yongpeng Ji, Yong Yang, Ning Zhang
According to current guidelines, partial nephrectomy remains the standard treatment for localized small renal tumors, intending to preserve kidney function and provide longer term tumor control [6]. Some theoretical questions regarding treating cystic renal tumors remain unanswered, especially concerns about cyst rupture and tumor implantation during surgery. Firstly, patients with renal cysts on preoperative imaging, receiving renal cyst unroofing, may be diagnosed as cystic renal cell carcinoma by postoperative pathology. Second, for patients with a high suspicion of cystic renal cell carcinoma, cyst rupture may occur during nephron-sparing surgery, and this carries the risk of tumor implantation and metastasis. The rate of cyst rupture during partial nephrectomy has been reported to be 20% [7,8].
How safe and effective is laparoscopic decortication of simple renal cysts in elderly patients?
Published in The Aging Male, 2020
Ali Akkoç, Cemil Aydın
In total, 114 patients were included in this study, comprising 48 (42.1%) female and 66 (57.9%) male with a mean age of 73.8 ± 8.2 years. Twenty-one (18.4%) of the patients had at least 1 previous unsuccessful cyst aspiration. Preoperative ASA score distributions were ASA-I in 12 patients (10.5%), ASA-II in 31 patients (27.2%), ASA-III in 68 patients (59.7%), and ASA-IV in 3 patients (2.6%). Simple renal cysts were localized on the right side in 61 (53.5%) patients and on the left side in 53 (46.5%) patients and mean cyst size was 72.83 ± 31.13 mm. Also, they were localized on the anterior in 88 (77.2%) patients and on the posterior of the kidney in 26 (22.8%) patients. Mean operative time was 43.4 ± 4.8 min. The characteristics of the patients are listed in Table 1. No intraoperative complications were recorded. Blood loss in all patients was minimal and could not be measured. Clavien grade 1 complications such as fever and delayed bowel movement were occurred in 8 (7%) patients. These patients were treated with antipyretic medications and/or intravenous hydration. No complication was observed during and after the operation in any of the 21 patients who had a history of renal cyst aspiration. Drainage tubes were removed on the first postoperative day except 3 patients with prolonged drainage. Median hospitalization time was 1 day (range 1–3 days). Pathological examinations of specimens were benign character in all cases. At 1- and 6-month follow-up, all patients were asymptomatic and no radiological recurrence was detected in any patients. Of the patients, 14 did not have 6-month follow-up.
Current and emerging treatment options to prevent renal failure due to autosomal dominant polycystic kidney disease
Published in Expert Opinion on Orphan Drugs, 2020
Gopala K. Rangan, Aarya Raghubanshi, Alissa Chaitarvornkit, Ashley N. Chandra, Robert Gardos, Alexandra Munt, Mark N. Read, Sayanthooran Saravanabavan, Jennifer Q.J. Zhang, Annette T.Y. Wong
It has been hypothesized that maintaining a water intake of greater than three liters per day may reduce the progression of renal cyst growth in ADPKD by suppressing AVP release [119], and this is supported by preclinical data [120]. However, the volume of water required to suppress AVP is dependent on amount of dietary solute intake and should be personalized [119]. Although this intervention is low-cost and simple, there is no high-level evidence to support this as a recommendation for clinical practice [69]. To date, short-term studies (<2 months in duration) demonstrate that vasopressin activation could be reduced at consumption volumes that are tolerable to patients [69,72,121]. However, the long-term efficacy (on renal function decline and renal cyst growth), safety and feasibility of this approach are not known. The only available long-term data in humans is a small non-randomized observational cohort study (n = 33) which showed that the progression of TKV or decline in eGFR in patients who drank 2.5–3.0 L per day was not different to those who consumed lower amounts over 1 year period [122]. This study was non-randomized and of insufficient duration and power [69]. Currently, two clinical trials are currently in progress to evaluate the long-term efficacy and safety of increased fluid intake in PKD [123,124] (Table 5).
Related Knowledge Centers
- Hounsfield Scale
- Kidney Cancer
- Medullary Sponge Kidney
- Nephrectomy
- Polycystic Kidney Disease
- Cancer
- Kidney
- Cystic Kidney Disease
- Septum
- Contrast CT