Cyst infection in acquired renal cystic disease.

Abstract

Cyst infection in acquired renal cystic diseaseCystic degeneration of the kidney in patients with advanced renal failure is common'; whether cysts can harbour infection remains to be shown.2 We report on three cases of infected cysts in acquired renal cystic disease. Case reportsCase I-A 60 year old man was admitted to hospital because of uraemia, hypertension, recurrent fever, and leucocytosis. The plasma concentration of creatinine was 821 !umol/l, and a urine culture was positive for Escherichia coli. Ultrasonography showed normal sized hyperechogenic kidneys with more than three 1-2 cm cysts in each. There was a 6 cm cyst that was hyperechogenic at the upper pole of the left kidney. Renal computed tomography confirmed the presence of bilateral multiple cysts. A thick wall, enhanced by contrast infusion, was seen around a slightly dense cyst on the upper pole of the left kidney (figure).

Imaging in the Dialysis Patient: Renal Imaging in Patients Requiring Renal Replacement Therapy

“…ARCD is recognized more frequently, due to increased awareness of the condition, improvements in imaging techniques, increased survival of patients on dialysis, and the trend for retention of the native kidneys (43). Most patients are asymptomatic, but may become symptomatic due to the complications of cysts, including perinephric hemorrhage, cyst infection, renal calculi, erythrocytosis, and the development of renal neoplasms (44)(45)(46)(47)(48)(49).…”

“…ARCD is recognized more frequently, due to increased awareness of the condition, improvements in imaging techniques, increased survival of patients on dialysis, and the trend for retention of the native kidneys (43). Most patients are asymptomatic, but may become symptomatic due to the complications of cysts, including perinephric hemorrhage, cyst infection, renal calculi, erythrocytosis, and the development of renal neoplasms (44–49). In patients with ESRD that is not due to hereditary renal cystic disease, the radiologic diagnosis can be made by US, CT, or MRI, with the identification of at least three noncomplicated cysts in the cortex or medulla of each kidney, ranging in size from 0.5 to 4 cm (50).…”