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Suggest Treatment For Removing Cortical Cyst In Kidneys

Posted on Mon, 21 Apr 2014

Question: I have an simple cortical cyst in the mid polar region of both kidneys. Left works at 65% the right at 35% based on Renal Flow Scan. Can these be operated on and if so, will it help increase my eGFR of 47? Thanks

Answered by Dr. Vivek Chail (5 hours later)

Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXX Thanks for writing in to us. I have read through your query in detail. As you might be aware, an eGFR of 47 relates to moderate decrease in glomerular filtration rate and eGFR of less than 15 shows kidney failure. It would be important to know the CT scan details of your kidney cysts regarding the exact size and location of the cysts before saying if the cysts can be operated or not. It is also important to know if you are having diabetes and hypertension. Your kidney function tests (serum creatinine and blood urea levels) are also important. Surgery might not always be the best solution. Reversal of eGFR may not be seen completely and it also depends on any other factors causing decreased eGFR. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (17 hours later)

Left kidney cortical cyst 1.4 x 1.1 x 1.4 cm simple cortical cyst at the mid polar region. Possible 0.2 cm calculus inferiorly. Right kidney simple cortical cyst at the mid polar region 2.6 x 2.4 x 2.5 cm. and an 0.5 x 0.4 x 0.6 cm calculus at the mid polar region. My creatinine serum level is 1.57 mg/dl. e-osmolality is 279.15 n/a. Uric acid 6.8 Kappa Light Chain free serm is 22.7 . Lambda Light Chain free serum is 14.5. And kapper/lambda light chains free with ratio, serum is 1.57 I have no diabetes or hypertension. My height is 5'3" tall and weight is 110 lbs. Kidney Doctor can't determine what is causing my kidney proplems. He is monitoring my condition. But I am anxious to know what it is. I've been seeing doctor for a little over a year now. ALL OTHER LAB RESULTS FOR URINE ARE NORMAL. Had urinary track infection but it was treated with antibiotics. However, there is still a trace of Leucocytes in urine with WBC between 21-24. Thank you.

Answered by Dr. Vivek Chail (13 hours later)

Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXX Thanks for writing in with an update. The cysts in kidney are small enough not to be causing any significant obstruction. They do not require to be operated. The stones are small but since you have one on each side, you may still take a medical treatment and also drink lots of water and fluids, especially during the summer. Your serum creatinine is slightly on the higher side but uric acid is normal. Normal test results for free light chains are: 3.3 to 19.4 mg/L kappa free light chains 5.71 to 26.3 mg/L lambda free light chains 0.26 to 1.65 ratio of kappa/lambda Going by above values kappa is slightly above normal and lambda is normal. Not much significance is to be attached to your results. You also do not report hypertension, diabetes or multiple myeloma which can be causing abnormalities that your eGFR results show. Putting these together I suppose you need to be carefully monitored for your kidney function and if necessary, a kidney can be done at a later stage. Please remember that a kidney biopsy is not required at the moment as most of the results are only slightly abnormal. You may take an opinion from another nephrologist. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (5 hours later)

Considering the above facts and since I don't have diabetes nor hypertension and since I'm following a Kidney Diet how long can I POSSIBLY remain in CKD Level 3. My eGFR has been fairly leveled ( between 42 and 50 without correction) for the last 14 months. Now it's at 47. Since my doctor can not identify what is causing my kidney desease is it wise to seek a second opinion at this time to find the possible cause? I don't want my kidney's to get progressively worse. Thank you.

Answered by Dr. Vivek Chail (14 hours later)

Brief Answer: Please find detailed answer below Detailed Answer: Hi XXXX Thanks for writing in with an update. Having eGFR of 47 puts you in CKD category 3A. This means moderate renal impairment. If eGFR is between 30 and 44 its 3B. Not having diabetes or hypertension and being on kidney diet can slow down the disease process. Factors which may worsen the condition are Proteinuria: protein in urine Haematuria of renal origin: blood in urine Declining GFR Young age Since you have mentioned that other tests are normal and you are in the seventh decade, your prognosis is better than in the young. I suggest you continue your periodic health checks. As per current trends, CKD 3A is managed by getting the following checks done 6 then 12 monthly or as felt by your doctor: 1. Creatinine and potassium 2. Hemoglobin 3. Urinary protein 4. Blood pressure 5. Cardiovascular risk - advice on smoking, exercise and lifestyle. Consider cholesterol lowering therapy if necessary 6. Immunization - influenza and pneumococcal 7. Medication review - regular review of medication to minimise nephrotoxic drugs (particularly NSAIDs) and ensure doses of others are appropriate to renal function. Most patients with Stage 3 CKD are older, and only a minority go on to get more serious kidney disease. Their increased rate of cardiovascular disease (heart attacks, strokes, narrowing of other arteries) is very important. I am unable to give you an exact time frame but reassure you that with precautions in place you need not worry much. My suggestion at going for a second opinion arises from your statement that your doctor is unable to come to a definitive diagnosis and the fact that I too dont want your kidneys to worsen and miss an opportunity for early treatment and cure. Hope your query is answered. Do write back if you have any doubts. Regards, Dr.Vivek

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Vivek Chail (11 hours later)

Thanks a million for your help and support. Truly appreciate it. The information you provided is invaluable. Thanks again.

Answered by Dr. Vivek Chail (10 hours later)

Brief Answer: Welcome Detailed Answer: Hi XXXX Thanks for writing in with an update. I am glad to have been able to reply to your queries. If you have any further queries to be answered by me then please quote your query ID 102579 and your query will be directed to me. I will reply to you at the earliest. Wishing you good health. Regards, Dr.Vivek

Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar