Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Patient ProfileGender: MaleAge: 35Visited A Doctor: YesMedications Tried: N/A I
Question: Patient ProfileGender: MaleAge: 35Visited a Doctor: YesMedications Tried: N/A
I have had elevated values of hematocrit, hemoglobin and rbcs for the last 5 years or so. My hematocrit is usually around 51 or 52%. I saw a hematologist who ran multiple tests: JAK2 mutation, JAK2 exon 12 mutation, CALC mutation and EPO test, all of which came back normal and negative for polycythemia vera.
I have a history of kidney stones when I was younger (likely from excessive protein during my high school sport days) so I get renal sonograms from time to time. I was born with a pelvic left kidney and a malrotated right kidney but they are essentially normal with no abnormalities.
In 2017, my renal sonogram noted "Newly seen 3.3cm cyst arising from the lower pole of the right kidney." The following year, the sonogram notes "2.8cm cyst not significantly changed". I saw a nephrologist and they said simple renal cysts are normal and since it didn't grow, it's not an issue at all.
However, the nephrologist didn't know about my elevated red blood cell values and I just came across this article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000 , which states: "Patients with simple renal cysts have high values of red blood cells, hematocrit, and hemoglobin. Treatment decreases blood pressure in patients with hypertension. Complications after treatment are rare and mild."
Is this correlation widely known and should I look into getting the renal cyst removed to help lower my RBC values to a normal level?
I have had elevated values of hematocrit, hemoglobin and rbcs for the last 5 years or so. My hematocrit is usually around 51 or 52%. I saw a hematologist who ran multiple tests: JAK2 mutation, JAK2 exon 12 mutation, CALC mutation and EPO test, all of which came back normal and negative for polycythemia vera.
I have a history of kidney stones when I was younger (likely from excessive protein during my high school sport days) so I get renal sonograms from time to time. I was born with a pelvic left kidney and a malrotated right kidney but they are essentially normal with no abnormalities.
In 2017, my renal sonogram noted "Newly seen 3.3cm cyst arising from the lower pole of the right kidney." The following year, the sonogram notes "2.8cm cyst not significantly changed". I saw a nephrologist and they said simple renal cysts are normal and since it didn't grow, it's not an issue at all.
However, the nephrologist didn't know about my elevated red blood cell values and I just came across this article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000 , which states: "Patients with simple renal cysts have high values of red blood cells, hematocrit, and hemoglobin. Treatment decreases blood pressure in patients with hypertension. Complications after treatment are rare and mild."
Is this correlation widely known and should I look into getting the renal cyst removed to help lower my RBC values to a normal level?
Brief Answer:
Simple renal cysts
Detailed Answer:
Thanks for the query
I understand that you are worried about simple renal cysts causing raised HCT. This could be true as kidneys produce a hormone known as Erythropoietin (EPO)which engages in increasing the Haemoglobin, in fact in people with kidney failure we inject them EPO once a week.
Simple renal cysts are very common and do not require any treatment unless they cause adverse effects like pain, grow in size or get infected. I would not consider laparoscopic removal of the cysts to bring down haemoglobin, the measure is indeed extraordinary if considered. EPO levels can be done to see if this is the cause for the high haemoglobin, other causes like smoking, JAK 2 mutation and Chronic lung problems I am sure are being considered by your doctor.
If you have any further queries please feel free to get back to me, I will be happy to get back to you
Thank you
Warm regards
Simple renal cysts
Detailed Answer:
Thanks for the query
I understand that you are worried about simple renal cysts causing raised HCT. This could be true as kidneys produce a hormone known as Erythropoietin (EPO)which engages in increasing the Haemoglobin, in fact in people with kidney failure we inject them EPO once a week.
Simple renal cysts are very common and do not require any treatment unless they cause adverse effects like pain, grow in size or get infected. I would not consider laparoscopic removal of the cysts to bring down haemoglobin, the measure is indeed extraordinary if considered. EPO levels can be done to see if this is the cause for the high haemoglobin, other causes like smoking, JAK 2 mutation and Chronic lung problems I am sure are being considered by your doctor.
If you have any further queries please feel free to get back to me, I will be happy to get back to you
Thank you
Warm regards
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you, Dr. Madhyastha.
I had my EPO tested twice and it was 7mU/mL (ref range: 3 - 26mU/mL) and then 10mU/mL the 2nd time so it seems to be in the normal range. Also, my JAK2 mutation was negative as well as the JAK2 exon 12 variant of the mutation was negative as well so my doctor thinks it's highly unlikely it's Polycythemia Vera. I saw a pulmonologist and they did a sleep study as well as normal breathing tests and everything came back "normal". I don't smoke or live at high altitude either.
Could this just be simple dehydration?
I had my EPO tested twice and it was 7mU/mL (ref range: 3 - 26mU/mL) and then 10mU/mL the 2nd time so it seems to be in the normal range. Also, my JAK2 mutation was negative as well as the JAK2 exon 12 variant of the mutation was negative as well so my doctor thinks it's highly unlikely it's Polycythemia Vera. I saw a pulmonologist and they did a sleep study as well as normal breathing tests and everything came back "normal". I don't smoke or live at high altitude either.
Could this just be simple dehydration?
Brief Answer:
Follow up
Detailed Answer:
Dear XXXXXXX
Thank you for getting back to me. Looks like all your test results are normal. How high is your haemoglobin? One has to be severely dehydrated for the haemoglobin to be high besides one cant imagine repeated tests to come back high due to dehydration.
The alternative to cystectomy would be to start you on low dose aspirin and at times I have started on ACE inhibitor to bring down the haemoglobin. In my career, I have never ordered a cystectomy for a simple cyst.
Thank you
Warm regards
Follow up
Detailed Answer:
Dear XXXXXXX
Thank you for getting back to me. Looks like all your test results are normal. How high is your haemoglobin? One has to be severely dehydrated for the haemoglobin to be high besides one cant imagine repeated tests to come back high due to dehydration.
The alternative to cystectomy would be to start you on low dose aspirin and at times I have started on ACE inhibitor to bring down the haemoglobin. In my career, I have never ordered a cystectomy for a simple cyst.
Thank you
Warm regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you. My haemoglobin ranges between 16.6 - 17.9 grams per deciliter, which is slightly above the normal range. I have ranged between those two numbers for the last 5 years or so.
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
