Kidney Cysts – Diagnosis and Treatment

Cysts are fluid-filled sacs that can grow in different parts of the body, including the kidneys. Most kidney cysts are simple, with thin walls and only fluid inside.

Simple cysts usually do not cause health problems. People often discover them by accident during imaging tests done for other reasons.

Understanding the features of kidney cysts helps you know when to pay closer attention.

Diagnosis

Doctors use imaging tests like ultrasound, MRI, or a CT scan to find kidney cysts. These tests help doctors tell the difference between a simple cyst, a complex cyst, or a tumor.

Doctors may also order blood tests to check how well your kidneys work. If you have blood in your urine (hematuria), your doctor may suggest more tests.

Imaging shows where the cyst is located in the kidney, such as the renal pelvis or another area.

Key steps in diagnosis:

• Ultrasound: Often the first imaging test used, it can show if a cyst is filled with fluid (simple cyst) or has solid areas (complex cyst).
• CT Scan: Provides detailed images of the kidney and helps doctors evaluate cyst structure, wall thickness, and any signs of cancer.
• MRI: May be used if further clarity is needed, especially when CT scans are inconclusive or if contrast dye cannot be used.
• Blood Tests: Assess kidney function by checking creatinine levels, glomerular filtration rate (GFR), and other important markers.
• Urinalysis: Checks for blood or protein in the urine, which can signal more serious kidney issues.
• Monitoring: Simple cysts often require no treatment and may just be monitored over time with repeat imaging to check for changes.

Treatment

Monitoring Small or Non-Problematic Cysts

Doctors often do not treat simple kidney cysts if they do not cause pain, infection, or kidney problems. In these cases, doctors recommend regular check-ups.

You may need ultrasounds or other imaging tests every few months or years. These tests track any changes in the cyst’s size or appearance. If the cyst does not change or cause issues, you do not need treatment.

Interventions for Symptomatic Kidney Cysts

If a kidney cyst causes pain, infection, or affects kidney function, doctors may suggest active treatment.

Options include:

1. Needle Aspiration and Sclerotherapy

   • The doctor uses an imaging test to guide a fine needle through the skin into the cyst.

   • The doctor drains the fluid and then adds a sclerosing solution, like alcohol, to help prevent the cyst from refilling.

   • You may feel some discomfort, but recovery is usually quick.

2. Minimally Invasive Surgery

   • If the cyst is large or causes serious symptoms, a surgeon may use small instruments to remove the cyst wall.

   • The surgeon makes small cuts and keeps your hospital stay short.

   • The surgeon drains the cyst and removes or seals its wall to keep it from coming back.

Doctors do not usually use dialysis or kidney transplants for simple cysts. These treatments are only considered if there is severe kidney damage or another serious condition.

Getting Ready for Your Visit

Actions You Can Take

Preparation makes your visit with the healthcare provider more useful. Bring a list of questions about your kidney cyst.

For example:

• What is the size of the cyst?
• Has this cyst appeared on earlier scans, or is it new?
• Is there a chance the cyst will get bigger?
• Is there any danger to the kidneys because of this cyst?
• Could any symptoms you are experiencing be from the cyst?
• Is surgery or another removal method needed?
• What treatments are available?
• What are the pros and cons of each treatment?
• Which warning signs should you watch out for?
• Do you need to see a kidney specialist?
• Are there any activities or foods you should avoid?
• Will you need to come back for more visits, and how often?

Take notes during your appointment, using paper or your phone. Bring a family member or friend to help remember what the doctor says.

Before your visit, you can:

Step	Reason
Write down symptoms	Ensures nothing important is missed
List medications	Helps the provider understand your health background
Organize health info	Keeps important documents and history easy to access

Bring past imaging results, blood tests, and other medical records. This helps your provider review your full history. Ask any new questions that come up during your appointment.

Questions Your Healthcare Provider May Raise

Your healthcare provider will ask questions to understand your health better. They may ask:

• Are you feeling any symptoms?
• How long have these symptoms been present?
• Have your symptoms changed or become worse?
• Is there blood in your urine?
• Do you have any pain in your lower back or sides?
• Have you experienced fever or chills?
• Do you have any other medical conditions?
• What medications, vitamins, or supplements are you currently using?

Your answers help your provider decide on next steps, such as more tests or seeing a kidney specialist.

Providers use this information to decide if you need more tests or if monitoring is best. Sometimes, they may suggest more imaging, blood tests, or a specialist review.