Renal cysts: Sonographic evaluation and classification in Sudanese adults

Abstract

Background: Renal cysts were common findings in the kidneys encountered in daily routine ultrasound examination. The majority is benign, but they can become complicated in the case of infection, hemorrhage, and ischemia. Sonographic evaluation plays a great role in classification and characterization of these lesions. Objective: The aim was to classify the renal cysts using ultrasound, to analyze the frequency of symptoms and signs, and to identify the significant factors. Materials and Methods: This is a cross-sectional prospective study conducted from September 2014 to December 2015. A total of 105 patients (78 males and 27 females) have been examined with ultrasound and confirm diagnosed with renal cysts. The sonographic criteria used for assessing renal cysts were wall-definition, thickness of septa, acoustic enhancement, shape and numbers of cysts, in addition to the genetic history of the family. Results: The incidence of renal cysts is significantly higher in male than female (74% vs. 26%, P= 0.01). Renal cysts were common in patients above 50 years old (80%). Aging was a significant factor of the renal cyst (P = 0.03) and size of the cysts was not significantly associated with age (P = 0.261). The majority of cysts was solitary (66%), unilateral (86%), and located in the right kidney (49%). The incidence of cortical simple renal was 73%, para-pelvic simple cysts was 17%, autosomal-dominant polycystic kidney disease (ADPKD) was 4.76%, and acquired cystic kidney disease (ACKD) was 4.76%. The majority of simple renal cysts were asymptomatic (75%). Hypertension and flank pain were the common symptoms of ADPKD and ACKD. Conclusion: Age and gender were significant risk factors of renal cysts. ADPKD and ACKD were less frequent among Sudanese adults. Hypertension and flank pain were the most common symptoms and signs of ADPKD and ACKD. Ultrasound plays an effective role to classify and assess renal cysts that help in management and follow-up.