Hepatic And Renal Cysts Treatment

Symptoms Of Liver Cysts

The majority of cysts cause no pain or other symptoms, but larger cysts can lead to bloating and pain in the upper right abdomen. There are some instances where a cyst can actually become so large that you can feel it through the abdomen. The concern is that very large cysts can have an impact on other organs, which may lead to symptoms of nausea, vomiting, poor appetite, and jaundice.

Parasitic cysts have been known to cause fever for some people. Bloody sputum and severe skin itching are other signs associated with parasitic cysts. There is one type of echinococcosis that can also cause symptoms similar to cirrhosis or liver cancer.

Inherited Cystic Renal Disease

Autosomal dominant polycystic kidney disease

Patients with autosomal dominant polycystic kidney disease have decreased ability to concentrate urine and should be encouraged to drink 1-2 L of water daily.

Generally, a blood pressure of 130/80 mm Hg is considered the treatment goal for hypertension in this population. Moderate hypertension may be treated with sodium restriction , exercise, and weight control. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are effective in controlling hypertension in ADPKD. However, ACE inhibitors have been associated with reversible renal failure in polycystic kidney disease. Calcium channel blockers also are effective in managing hypertension in ADPKD.

Hypertension appears to correlate with the size of the cyst, and aspiration of renal cysts results in a reduction of blood pressure.

Prevention of infection with appropriate precautions is important, particularly in women. Avoid urinary tract instrumentation whenever possible.

Autosomal recessive polycystic kidney disease

Infants with autosomal recessive polycystic kidney disease should be delivered at a facility with a neonatal intensive care unit of level IV. The newborn should be provided supportive therapy while the degree of pulmonary insufficiency and the etiology is reviewed.

Dialysis may be required for renal failure. In one case series, neonates with ESRD before 28 days of age had 1-year survival of 52% and 5-year survival of 48% with peritoneal dialysis.

Imaging Assessment Of Symptomatic Pld

CT scan with intravenous contrast is the principal imaging tool for radiological assessment of patients with PLD who do not have associated renal failure. Unless there has been intracystic hemorrhage, the cysts have a homogeneous fluid content with thin avascular walls that do not enhance with IV contrast. Fine calcification may occur in less than 2% of cases, especially after intracystic hemorrhage. In the majority of cases, treatment choices can be made based on CT findings. The points

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Hepatic Cysts In Autosomal Dominant Polycystic Kidney Disease

• Gregory T. Everson, M.D. 1Author Footnotes1 Address reprint requests to Dr. G. T. Everson, Gastroenterology Division, Box B-158, University of Colorado Health Sciences Center, 4200 East Ninth Avenue, Denver, CO 80262.Gregory T. EversonFootnotes1 Address reprint requests to Dr. G. T. Everson, Gastroenterology Division, Box B-158, University of Colorado Health Sciences Center, 4200 East Ninth Avenue, Denver, CO 80262.Affiliations
• Show footnotesHide footnotesAuthor Footnotes1 Address reprint requests to Dr. G. T. Everson, Gastroenterology Division, Box B-158, University of Colorado Health Sciences Center, 4200 East Ninth Avenue, Denver, CO 80262.

ProceedingsAnn Intern Med.Adv Nephrol.Nature.N Engl J Med.

What Causes Polycystic Kidney Disease

People who have PKD were born with it. PKD is almost always inherited from a parent or from both parents. People of all genders, ages, races, ethnicities and nationalities can have PKD. Men and women get PKD equally as often. If you have a blood relative with PKD, you are more likely to have PKD or carry the gene that causes it. If you carry the gene that causes PKD but you do not have the disease, you are called a carrier. This is possible with autosomal recessive PKD.

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What Is Polycystic Liver Disease

Polycystic liver disease is the development of multiple cysts in the liver. PLD cysts may cause pain, but they usually do not affect liver function. If PLD starts affecting liver function or becomes too painful, surgery may be needed. However, cysts can reoccur after surgery.

People with PLD are born with it, but usually do not have large cysts until they are adults. Polycystic liver disease is genetic. When it is found in one family member, all family members should be tested. PLD may be detected using an ultrasound or CT scan. It is more common in women than men.

Most people with PLD also have polycystic kidney disease , which are cysts in the kidneys that can cause high blood pressure and kidney failure. Sometimes a liver transplant and a kidney transplant may be necessary.

Infected Hepatic And Renal Cysts: Differential Impact On Outcome In Autosomal Dominant Polycystic Kidney Disease

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Liver Cysts Natural Home Remedies

There are different ways to address a cyst on the liver with natural treatment when they are simple cysts. The following are natural home remedies that in some cases gradually shrink the cysts.

• Avoid dairy hormones present in dairy products encourage the growth of cysts.
• Minimize exposure substances such as alcohol, environmental chemicals, excess sugar, and some medications can cause damage to liver cells
• Liver tonic it can help protect liver cells and repair damaged liver cells
• Selenium supplement selenium has been known to protect liver cells
• Raw vegetable juices vegetables like kale, broccoli, radishes, and onions are good for the liver
• Minimize fats saturated fats, trans-fats, and fermented foods can aggravate symptoms, such as bloating
• Dandelion root helps to alleviate some of the symptoms linked to cysts
• Lemon juice consuming freshly squeezed lemon juice three times a day can help detoxify the liver

Ct Or Mri: Advantages And Disadvantages

Contrast-enhanced CT is the modality of choice in evaluating cystic renal masses. Narrow detector thickness and intravenous administration of contrast agent are mandatory to detect thin septa and small enhancing nodules . Also, demonstration of enhancing areas helps differentiate solid components from hemorrhage or debris . MRI is used when CT is contraindicated or as a problem-solving modality for equivocal findings. Indeed, MRI can show some septa that are less apparent at CT and demonstrate definitive enhancement in those cysts that show only equivocal enhancement at CT . As a consequence, renal cysts can be placed in a higher Bosniak category with MRI than with CT .

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Pearls And Other Issues

The most common associated disease with infantile polycystic kidney disease is Caroli disease of the liver and hepatic fibrosis. There are many associated findings of adult polycystic kidney disease including berry aneurysms, hypertension, liver cysts, and cysts within different organs. There is an association of VACTERAL and congenital heart disease with obstructive cystic renal dysplasia.

What Are The Symptoms Of Polycystic Liver Disease

Most of the time, people with polycystic liver disease have no symptoms. However, if the liver becomes very enlarged and bulky with cysts, symptoms may include:

• Bloating or swelling in the abdomen
• Shortness of breath

Only about one out of every 10 people with PLD has problems associated with it. In addition to severe abdominal pain, other complications may include:

• Bleeding into a cyst
• Bile duct obstruction and jaundice

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How Is Polycystic Liver Disease Diagnosed

Because symptoms do not always occur, many people learn they have PLD incidentally or after a diagnosis of kidney disease related to polycystic kidney disease.

An ultrasound is typically the first test used to look for the presence of liver cysts. The fact that you may have a few cysts does not mean you have polycystic liver disease because there are other more common causes of cysts in the liver. Many factors are involved in diagnosing PLD, including family history, age, and number of cysts.

You may be diagnosed with polycystic liver disease if:

• You have a family member with PLD, are under the age of 40, and have more than one cyst.
• You have a family member with PLD, are older than 40, and have more than three cysts.
• You have no family members with PLD, are over the age of 40, and have more than 20 cysts.

Causes Of A Liver Cyst

Liver cysts are the result of a malformation in the bile ducts, although the exact cause of this malformation is unknown. Bile is a fluid made by the liver, which aids in digestion. This fluid travels from the liver to the gallbladder through ducts or tube-like structures.

Some people are born with liver cysts, whereas others dont develop cysts until theyre much older. Even when cysts are present at birth, they might go undetected until symptoms arise later in adulthood.

Theres also a link between liver cysts and a parasite called echinococcus. This parasite is found in areas where cattle and sheep live. You can become infected if you ingest contaminated food. The parasite can cause the development of cysts in different parts of the body, including the liver.

In the case of PLD, this disease can be inherited when theres a family history of the condition, or the disease may occur for no apparent reason.

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What Are Simple Kidney Cysts

Simple kidney cysts are fluid-filled sacs, or cysts, that can form in one or both of your kidneys. You can have just one cyst or you can have many. Simple kidney cysts are usually round or oval in shape. They can range from the size of a pea to the size of a golf ball.

Simple kidney cysts are usually harmless. Simple kidney cysts dont enlarge the kidneys, replace their normal structure, or cause reduced kidney function like cysts do in people with polycystic kidney disease . PKD is a genetic disorder that can cause chronic kidney disease.

How Do Health Care Professionals Diagnose Simple Kidney Cysts

Simple kidney cysts usually dont cause symptoms, so health care professionals often find simple kidney cysts when they are performing an imaging test for another reason. Health care professionals may use imaging tests and lab tests to rule out other, more serious problems, including some kidney cancers. If you are diagnosed with a simple kidney cyst, you usually dont need further testing or treatment.

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What Questions Should I Ask My Doctor

Many times, liver cysts grow undetected until they show up during routine imaging tests. Some questions to ask your healthcare provider that may help you understand next steps in dealing with this unexpected diagnosis include:

• How do I know whether my cyst is benign or cancerous?
• What kind of tests will I need?
• Will I need to have a liver biopsy performed?
• Can you remove a cyst if its making me uncomfortable or causing pain?
• Will you monitor my cyst over time to check on its size and location over time?
• If I have liver cysts, should I get other kinds of testing to check for cysts anywhere else in my body?

A note from Cleveland Clinic

Most people first learn they have liver cysts during tests for other reasons. While no one likes hearing about an unexpected health issue, it may help to know that nearly all liver cysts are benign and rarely cause symptoms that could affect your quality of life. Often, healthcare providers choose to monitor cysts rather than do surgery to remove them. If youre concerned about liver cysts, ask your healthcare provider for information about your situation so you know what to expect.

Last reviewed by a Cleveland Clinic medical professional on 03/08/2022.

References

What Are Liver Cyst Symptoms

Most people who have benign or cancerous liver cysts never have symptoms. Those who do may have the following symptoms:

• Dull pain in the upper right area of their bellies.
• Bloated or distended bellies.
• Being able to feel large lumps in their belly.
• Jaundice. This may happen if liver cysts block your bile ducts.
• Fever and acute belly pain. This may happen if a cyst ruptures.

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How Are Renal Cysts Diagnosed And Evaluated

Since they rarely cause symptoms, renal cysts are most often found during imaging tests performed for other reasons. In such cases without any symptoms, simple renal cysts are usually left alone and do not need any further tests. However, some renal cysts look more complex than the usual simple renal cyst. These complex renal cysts can have a thicker wall, or solid material inside instead of just fluid. Once complex renal cysts are discovered, additional imaging tests may be performed to monitor them and distinguish benign cysts from cancer.

Some types of imaging tests your doctor might order include:

Abdominal Ultrasound and Pelvic Ultrasound: These exams are performed to take pictures of the kidneys and confirm the presence of fluid inside the renal cysts. Your doctor may use ultrasound imaging to monitor renal cysts for any changes over time.

For more information about ultrasound performed on children, visit the Pediatric Abdominal Ultrasound page.

Abdominal and Pelvic CT: Often used as a complement to ultrasound in the study of complex renal cysts, this procedure can help distinguish benign cysts from tumors in the kidneys. A CT scan may include an injection of contrast material. See the Radiation Dose page for more information about CT procedures.

For more information about CT performed on children, visit the Pediatric CT page.

How Is Polycystic Liver Disease Treated

Treatment is usually not needed unless you have symptoms. Mild pain associated with PLD can be treated with pain medication. However, if the cysts cause significant discomfort or other complications, there are a number of treatment options. Which option is best for you will depend on the extent of your pain, the location of the cysts, and other complications. Treatments may include:

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Localized Cystic Renal Disease

Localized cystic renal disease is a rare, nonhereditary, form of cystic renal disease, which manifests as a conglomeration of multiple simple cysts of variable size . In contrast to ACKD and ADPKD, localized cystic renal disease is typically unilateral and not progressive. The disease usually involves only a portion of the kidney with a polar predilection . Entire renal involvement is rare . The contralateral kidney is normal. The presence of interposed normal renal parenchyma and the absence of a capsule help to differentiate localized cystic renal disease from cystic nephroma and multiloculated cystic RCC . Cystic involvement of other organs is typically absent .

Fig. 13

Localized cystic renal disease. Axial contrast-enhanced CT image shows a conglomeration of multiple simple cysts of variable size in the right kidney

How To Treat A Liver Cyst

Your doctor may choose not to treat a small cyst, instead suggesting a wait-and-see approach. If the cyst becomes larger and causes pain or bleeding, your doctor may discuss treatment options at that time.

One treatment option involves inserting a needle into your abdomen and surgically draining fluid from the cyst. This procedure may only provide a temporary fix, and the cyst may refill with fluid later on. To avoid a recurrence, another option is to surgically remove the entire cyst.

Your doctor can complete this surgery using a technique called laparoscopy. This minimally invasive procedure only requires two or three small incisions, and your doctor performs the surgery using a small instrument called a laparoscope. Typically, youll only remain in the hospital for one night, and it only takes two weeks to make a full recovery.

Once your doctor has diagnosed a liver cyst, they may order a blood test to rule out a parasite. If you have a parasite, youll receive a course of antibiotics to treat the infection.

Some incidents of PLD are severe. In this case, cysts may bleed heavily, cause intense pain, recur after treatment, or begin to affect liver function. In these situations, your doctor may recommend a liver transplant.

There doesnt appear to be any known way to prevent a liver cyst. In addition, there isnt enough research to determine whether diet or smoking contributes to liver cysts.

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How Is Pkd Treated

At present, there is no cure for PKD. However, a lot of research is being done. Recent studies suggest that drinking plain water throughout the day and avoiding caffeine in beverages can slow the growth of cysts. Research is also helping us understand the genetic basis of PKD.

Studies also suggest that some treatments may slow the rate of kidney disease in PKD, but further research is needed before these treatments can be used in patients. In the meantime, many supportive treatments can be done to control symptoms, help slow the growth of cysts, and help prevent or slow down the loss of kidney function in people with PKD. These include:

• careful control of blood pressure
• prompt treatment with antibiotics of a bladder or kidney infection
• lots of fluid when blood in the urine is first noted
• medication to control pain
• a healthy lifestyle with regard to smoking cessation, exercise, weight control and reduced salt intake
• drinking lots of plain water throughout the day
• avoiding caffeine in all beverages

In April 2018, the FDA approved a new drug called tolvaptan for the treatment of autosomal dominant polycystic kidney disease . The drug can be used to help slow kidney function decline in adults at risk for this type of PKD. You can speak with a healthcare professional for more information about this treatment and if its right for you.