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Renal cysts
Other Resources UpToDate PubMed

Renal cysts

Contributors: Abhijeet Waghray MD, Paritosh Prasad MD
Other Resources UpToDate PubMed


Renal cysts are abnormal fluid-filled sacs within the kidney that can occur at any age. Approximately 1 in every 3 adults over the age of 50 has a renal cyst, with a higher prevalence in males. Renal cysts can be characterized by morphology (simple versus complex), malignant potential (Bosniak classification), or etiology of cysts (congenital or acquired).

Simple renal cysts are common renal lesions (70%); the majority are benign, and further imaging is not required.  

The most common form of cystic renal disease is due to autosomal dominant polycystic kidney disease (PKD) and accounts for 8%-10% of all causes of end-stage renal disease. The develoment of renal cysts has also been associated with diuretic use as well as some medications.

The presentation of renal cysts varies based on the cause, and physical examination may reveal a palpable flank or abdominal mass. Radiographic findings of a thick irregular wall, thick septations, or multilocular findings are concerning for malignancy.


N28.1 – Cyst of kidney, acquired
Q61.00 – Congenital renal cyst, unspecified

722223000 – Cyst of kidney

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Categories of renal cysts are:
  • Developmental – Multicystic dysplastic kidney, uniformly diagnosed on prenatal ultrasound; Medullary sponge kidney
  • Genetic – Autosomal dominant Polycystic kidney disease, autosomal recessive Polycystic kidney diseaseAutosomal dominant tubulointerstitial kidney disease, glomerulocystic kidney disease, and juvenile Nephronophthisis
  • Associated with systemic disease – Von Hippel-Lindau disease and Tuberous sclerosis
  • Acquired – Simple cysts, acquired cystic renal disease, Lithium nephropathy (microcysts in the medulla and cortex), angiomyolipoma, metanephric adenoma, cystic oncocytoma
  • Malignancy-associated – Cystic Renal cell carcinoma, Lymphoma

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Management Pearls

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Reviewed:03/06/2018
Last Updated:04/18/2018
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Renal cysts
A medical illustration showing key findings of Renal cysts : Flank pain, Abdominal mass, Hematuria, BP increased
Imaging Studies image of Renal cysts - imageId=7885061. Click to open in gallery.  caption: '<span>Enhanced CT scan demonstrating left renal cyst.</span>'
Enhanced CT scan demonstrating left renal cyst.
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