Simple renal cysts in the solitary kidney: Are they innocent in adult patients?
Today, chronic kidney disease (CKD) is an important global epidemic public health problem. The progression of CKD increases the need of dialysis and related expenses and is associated with high mortality. The presence of systemic diseases such as diabetes, hypertension, metabolic syndrome and obesity as well as disease‐specific complications like uremia, metabolic asidosis, phosphate retention and activated renin‐angiotensin cascade, may contribute to the acceleration of CKD 1. Solitary kidney in childhood is known to be an independent risk factor for hypertension, proteinuria and CKD progression 3. However, for the adults, the data on this subject is often limited to the evaluation of otherwise healthy individuals who underwent donor nephrectomy. In this population, progression to end‐stage renal disease is quite uncommon 6. On the contrary, when adult patients with indication nephrectomy are considered; despite the lack of adequate data, older age and the presence of excess comorbidities and risk factors (diabetes, hypertension, obesity, urinary stone disease) may possibly lead to progressive damage to the solitary kidney.
May rather show geographic differences, simple renal cysts are common in different societies. Male gender and age are important risk factors 8. Although not seen much in the first three decades of life, the incidence is 1–3% in the third, 15–20% between the fourth and sixth decade and as high as 35% in the seventh decade 9. Acquired renal cysts are considered to have benign clinical course, but sometimes may be associated with hypertension, vascular disease, kidney damage and renal dysfunction 10. Besides,the association between renal cysts in a solitary kidney and kidney outcome is still obscure.
The aim of this study is to investigate the incidence of renal cysts in the solitary kidney and to examine the effect of these cysts on progression of kidney failure in patients with previous indication nephrectomy (IN).