Yıl 2021, Cilt 14 , Sayı 2, Sayfalar 460 - 465 2021-04-01

Çocuklarda böbrekte basit kist
Simple renal cyst in children

Berfin UYSAL [1]


Amaç: Erişkinlerde sık görülen ve ilerleyen yaş ile insidansı artan böbrek kistleri çocuklarda göreceli olarak nadirdir. Düşük malignite riski nedeni ile erişkinlerde takip önerilmeyen basit kistlerin çocuklardaki takibi ile ilgili uzlaşılmamıştır. Bu çalışmada basit böbrek kistinin tanısı, takibi ve izlemde karşılaşılabilecek sorunlara değinilmiştir.
Gereç ve yöntem: Basit böbrek kisti tanısı ile Aralık 2016-Aralık 2020 tarihleri arasında tek merkezden en az 1 yıl boyunca izlenmiş 18 yaş altı hastalar retrospektif olarak incelenmiş, hastaların demografik, klinik ve radyolojik verileri değerlendirilmiştir.
Bulgular: Yirmi yedisi erkek, toplam 48 hastanın tanı anında yaş ortalaması 87,96±54,82 ay, ortalama takip süresi 29,72±17,63 ay olarak bulundu. Yirmi dokuz hastanın başvuru esnasında şikâyeti yokken (farklı endikasyonlar nedeni ile yapılan US’de farkedilen) 11 hastada karın ağrısı, 4 hastada idrar yolu enfeksiyonu, 4 hastada enürezis mevcut idi. Otuz altı hastada tam idrar tetkiki normal, 5 hastada piyüri, 3 hastada hematüri, 1 hastada proteinüri, 3 hastada piyüri ve hematüri birlikteliği mevcut idi. Kistlerin %41,7’si üst pol, %27’si alt pol, %31,3’ü mediorenal yerleşimli, 24 hastanın kisti sağ tarafta iken, 21 hastanın sol tarafta ve 3 hastanın bilateral yerleşimli olarak bulundu. Başvuru esnasında ortalama kist çapı 20,38±12,87 mm olarak ölçüldü. Takipte 9 hastada kist boyutlarında artış görülürken, izlemde 1 hastanın kistinin kaybolduğu görüldü.
Sonuç: Sonuç olarak, ayrıntılı bir ultrasonografik inceleme ile tanı alabilecek evre 1 ve evre 2 basit böbrek kistlerinde malign dönüşüm ve cerrahi endikasyon gerekliliği nadiren görülse de, takiplerinde evre artışı, ODPKB hastalığı, hipertansiyon ya da böbrek fonksiyon bozukluğu gibi ortaya çıkabilecek durumlar nedeni ile izlemleri gereklidir.

Purpose: Renal cysts, which are common in adults are relatively rare in children. . Due to the low risk of malignancy, follow-up of simple renal cysts in adults is not recommended where as there is no consensus on the follow-up of children with simple renal cysts. In this study, diagnosis, folllow-up and the problems that may be encountered through the follow-up of simple renal cysts are discussed.
Materials and methods: Children under 18 years of age who were monitored at a single center for at least 1 year between 2016-2020 with the diagnosis of simple renal cyst were retrospectively examined and demographic, clinical and radiological data were evaluated.
Results: A total of 48 patients (27 boys) had a mean age of 87.96±54.82 months at the time of diagnosis, and a mean follow-up period of 29.72±17.63 months. Twenty-nine patients had no complaints at the time of admission, 11 patients had abdominal pain, 4 patients had urinary tract infection, and 4 patients had enuresis. Urinalysis was normal in 36 patients 5 patients had pyuria, 3 patients had hematuria, 1 patient had proteinuria, 3 patients had pyuria and hematuria. The cysts of 24 patients were located on the right side, 21 patients were located on the left side and 3 patients were located bilaterally, while 41.7% of the cysts were located in the upper pole 27% in the lower pole, 31.3% in the mediorenal. The mean diameter of the cyst at presentation was measured as 20.38±12.87 mm. While an increase in the size of the cyst was observed in 9 patients, it was observed that the cyst of 1 patient disappeared in the follow-up.
Conclusion: Although malignant transformation and the necessity of surgical indication are rarely seen in stage 1 and stage 2 simple renal cysts that can be diagnosed with a detailed ultrasonographic examination, follow-up is required because of conditions that may occur such as increased stage, ADPKD disease, hypertension or renal dysfunction.

  • 1. Karmazyn B, Tawadros A, Delaney LR, et al. Ultrasound classification of solitary renal cysts in children. J Pediatr Urol. 2015;11:149 e1.
  • 2. Wang Z.T.P, Chan E.P, Moreno N.V et al. What to Do With Renal Cysts in Children? Urology.2020;140:138-142.
  • 3. O'Kelly F, McAlpine K, Abdeen N, et al. The prevalence, clinicodemographics, and outcomes of incidental and symptomatic renal cysts in a pediatric cohort undergoing ultrasonography. J Urol. 2019;202:394.
  • 4. Eknoyan G. A clinical view of simple and complex renal cysts. J Am Soc Nephrol. 2009;20:1874-1876.
  • 5. McHugh K, Stringer DA, Hebert D, et al. Simple renal cysts in children: diagnosis and follow-up with US. Radiology. 1991;178:383-385.
  • 6. Koutlidis N, Joyeux L, Mejean N, Sapin E. Management of simple renal cyst in children: French multicenter experience of 36 cases and review of the literature. J Pediatr Urol. 2015;11:113 -7.
  • 7. Cramer MT, Guay -Woodford LM. Cystic kidney disease: a primer. Adv Chronic Kidney Dis. 2015;22:297 -305.
  • 8. Eroglu FK, Kargın Çakıcı E, Can G, et al. Retrospective analysis of simple and stage II renal cysts: Pediatric nephrology point of view. Pediatr Int. 2018; 60:1068-1072.
  • 9. Wallis MC, Lorenzo AJ, Farhat WA, Bagli DJ, Khoury AE, Pippi Salle JL. Risk assessment of incidentally detected complex renal cysts in children: potential role for a modification of the Bosniak classification. J Urol. 2008;180:317–321.
  • 10. National High Blood Pressure Education Program Working Group on High Blood Pressure in C, Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(2 Suppl 4th Report):555 -76.
  • 11. Schwartz GJ, Munoz A, Schneider MF, Mak RH, Kaskel F, Warady BA, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol. 2009;20(3):629 -37.
  • 12. Tada S, Yamagishi J, Kobayashi H, et al. The incidence of simple renal cyst by computed tomography. Clin Radiol. 1983;34:437-9.
  • 13. Skolarikos A, Laguna MP, de la Rosette JJ. Conservative and radiological management of simple renal cysts: a comprehensive review. BJU Int. 2012;110:170-8.
  • 14. Bosniak MA. The current radiological approach to renal cysts. Radiology. 1986;158:1-10.
  • 15. Blazer S, Zimmer EZ, Blumenfeld Z, et al. Natural history of fetal simple renal cysts detected in early pregnancy. J Urol. 1999;162:812-4.
  • 16. Rediger C, Guerra LA, Keays MA, et al. Renal cyst evolution in childhood: a contemporary observational study. J Pediatr Urol. 2019; 15:188.e1-188.e6.
  • 17. Adachi T, Nakatani T, Minami H, et al. Renal cell carcinoma with hemorrhagic cyst formation in a 4-year-old boy. Int J Urol. 2003;10:267-70.
  • 18. Kadekawa K, Miyazato M, Saito S, et al. Renal cell carcinoma originating in a renal cyst in a 12-year-old girl. J Pediatr Surg. 2009;44:e5-7.
  • 19. Henske EP, Thorner P, Patterson K, et al. Renal cell carcinoma in children with diffuse cystic hyperplasia of the kidneys. Pediatr Dev Pathol. 1999;2:270-4.
  • 20. Peng Y, Jia L, Sun N, et al. Assessment of cystic renal masses in children: comparison of multislice computed tomography and ultrasound imaging using the Bosniak classification system. Eur J Radiol. 2010;75:287-92.
  • 21. Saltzman AF, Carrasco Jr. A, Colvin AN, et al. Can a modified Bosniak classification system risk stratify pediatric cystic renal masses? J Urol. 2018;200:434-439.
  • 22. Bayram MT, Alaygut D , Soylu A, Serdaroğlu E, Cakmakcı H, Kavukçu S. Clinical and radiological course of simple renal cysts in children. Urology.2014;83:433-7.
  • 23. Simms RJ, Ong AC. How simple are 'simple renal cysts'? Nephrol Dial Transplant. 2014;29 Suppl 4:106-12.
  • 24. Garcia Nieto V, Dublan Garcia K, Luis Yanes MI. Are simple renal cysts another manifestation of prelithiasis in infancy? Nefrologia. 2010;30:337-341.
  • 25. Chang CC, Kuo JY, Chan WL, et al. Prevalence and clinical characteristics of simple renal cyst. J Chin Med Assoc. 2007;11: 486-491.
  • 26. Chin HJ, Ro H, Lee HJ, Na KY, Chae DW. The clinical significances of simple renal cyst: Is it related to hypertension or renal dysfunction? Kidney Int. 2006;70:1468 -73.
  • 27. Lee CT, Yang YC, Wu JS, Chang YF, Huang YH, Lu FH, et al. Multiple and large simple renal cysts are associated with prehypertension and hypertension. Kidney Int. 2013;83:924 -30.
  • 28. Al -Said J, Brumback MA, Moghazi S, Baumgarten DA, O'Neill WC. Reduced renal function in patients with simple renal cysts. Kidney Int. 2004;65:2303 -8.
Birincil Dil tr
Konular Pediatri
Yayınlanma Tarihi Nisan 2021
Bölüm Araştırma Makalesi
Yazarlar

Orcid: 0000-0001-6267-0454
Yazar: Berfin UYSAL (Sorumlu Yazar)
Kurum: Bursa Şehir Hastanesi, Sağlık Bilimleri Üniversitesi
Ülke: Turkey


Tarihler

Yayımlanma Tarihi : 1 Nisan 2021

Bibtex @araştırma makalesi { patd881115, journal = {Pamukkale Tıp Dergisi}, issn = {}, eissn = {1308-0865}, address = {Pamukkale Üniversitesi Tıp Fakültesi Eğitim Blokları Kınıklı kampüsü 20070 Kınıklı, Denizli}, publisher = {Pamukkale Üniversitesi}, year = {2021}, volume = {14}, pages = {460 - 465}, doi = {10.31362/patd.881115}, title = {Çocuklarda böbrekte basit kist}, key = {cite}, author = {Uysal, Berfin} }
APA Uysal, B . (2021). Çocuklarda böbrekte basit kist . Pamukkale Tıp Dergisi , 14 (2) , 460-465 . DOI: 10.31362/patd.881115
MLA Uysal, B . "Çocuklarda böbrekte basit kist" . Pamukkale Tıp Dergisi 14 (2021 ): 460-465 <https://dergipark.org.tr/tr/pub/patd/issue/60284/881115>
Chicago Uysal, B . "Çocuklarda böbrekte basit kist". Pamukkale Tıp Dergisi 14 (2021 ): 460-465
RIS TY - JOUR T1 - Çocuklarda böbrekte basit kist AU - Berfin Uysal Y1 - 2021 PY - 2021 N1 - doi: 10.31362/patd.881115 DO - 10.31362/patd.881115 T2 - Pamukkale Tıp Dergisi JF - Journal JO - JOR SP - 460 EP - 465 VL - 14 IS - 2 SN - -1308-0865 M3 - doi: 10.31362/patd.881115 UR - https://doi.org/10.31362/patd.881115 Y2 - 2021 ER -
EndNote %0 Pamukkale Tıp Dergisi Çocuklarda böbrekte basit kist %A Berfin Uysal %T Çocuklarda böbrekte basit kist %D 2021 %J Pamukkale Tıp Dergisi %P -1308-0865 %V 14 %N 2 %R doi: 10.31362/patd.881115 %U 10.31362/patd.881115
ISNAD Uysal, Berfin . "Çocuklarda böbrekte basit kist". Pamukkale Tıp Dergisi 14 / 2 (Nisan 2021): 460-465 . https://doi.org/10.31362/patd.881115
AMA Uysal B . Çocuklarda böbrekte basit kist. Pam Tıp Derg. 2021; 14(2): 460-465.
Vancouver Uysal B . Çocuklarda böbrekte basit kist. Pamukkale Tıp Dergisi. 2021; 14(2): 460-465.
IEEE B. Uysal , "Çocuklarda böbrekte basit kist", Pamukkale Tıp Dergisi, c. 14, sayı. 2, ss. 460-465, Nis. 2021, doi:10.31362/patd.881115