title: Simple renal cysts in the solitary kidney: Are they innocent in adult patients?
abstract: In patients with a solitary kidney; residual renal volume is an important prognostic factor for kidney survival. At present, the impact of renal cysts on solitary kidney survival is not clear. The aim of this study is to examine the association of cysts on progression of renal failure in patients with a solitary kidney.
  
  
  METHODS
  This study included sixtyfive solitary kidney patients. The remaining kidneys after indication nephrectomy (IN) were evaluated with urinary system ultrasound. The primary outcome of the study is the progression of kidney failure during follow-up which was defined as: 25% decrease in glomerular filtration rate (GFR) and / or the need for renal replacement therapy (RRT).
  
  
  RESULTS
  The mean age of the patients was 55 ± 14 years and mean follow-up was 53 ± 27 months. Renal cysts were present in 30.7% of patients. 33.8 percent of patients had kidney disease progression and 10.7 % required RRT. Those with progressive disease were older (61 ± 13, 52 ± 14; P = 0.011), had lower baseline GFR (30 ± 11, 39 ± 18; P = 0.035), higher proteiuria (2.84 ± 0.58, 2.47 ± 0.57; P = 0.031) and frequently harboring cysts in the solitary kidney (52.3%, 20.4%; P = 0.006). Progression to kidney failure and RRT requirement in cases with or without renal cysts was (60% vs. 22%; P = 0.004) and (20% vs. 6.6%; P = 0.123), respectively. Acquired cysts in solitary kidney was independently associated with progression to kidney failure and RRT respectively (Exp(B) 3.173; P = 0.01 and Exp(B) 12.35; P = 0.04).
  
  
  CONCLUSIONS
  Simple renal cysts in solitary kidney patients with impaired renal function is associated with poor renal outcome. Large-scale studies are needed to clarify this issue.
authors.affiliation: Izmir Bozyaka Education and Research Hospital, Department of Nephrology, Izmir, Turkey.
authors.forename: Erhan
authors.initials: E
authors.lastname: Tatar
authors.affiliation: Izmir Bozyaka Education and Research Hospital, Department of Internal Medicine, Izmir, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Ozay
authors.affiliation: Izmir Bozyaka Education and Research Hospital, Department of Internal Medicine, Izmir, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Atakaya
authors.affiliation: Izmir Bozyaka Education and Research Hospital, Department of Nephrology, Izmir, Turkey.
authors.forename: Pinar Kezban
authors.initials: PK
authors.lastname: Yeniay
authors.affiliation: Izmir Bozyaka Education and Research Hospital, Department of General Surgery, Izmir, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Aykas
authors.affiliation: Izmir Bozyaka Education and Research Hospital, Department of General Surgery, Izmir, Turkey.
authors.forename: Gokalp
authors.initials: G
authors.lastname: Okut
authors.affiliation: Izmir Bozyaka Education and Research Hospital, Department of Urology, Izmir, Turkey.
authors.forename: Tarik
authors.initials: T
authors.lastname: Yonguc
authors.affiliation: Izmir Bozyaka Education and Research Hospital, Department of Radiology, Izmir, Turkey.
authors.forename: Cetin
authors.initials: C
authors.lastname: Imamoglu
authors.affiliation: Izmir Bozyaka Education and Research Hospital, Department of General Surgery, Izmir, Turkey.
authors.forename: Adam
authors.initials: A
authors.lastname: Uslu
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology*; D052177:Kidney Diseases, Cystic / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects*; D051437:Renal Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014463:Ultrasonography
keywords: chronic kidney disease; nephrectomy; renal cyst; renal outcome; solitary kidney