Medullary cysts are found in two widely different conditions.
In medullary sponge kidney the cysts are confined to the papillary collecting ducts. Affected patients, usually adults, present with pain, haematuria, stone, or urinary infection. The diagnosis is made by IVU. Contrast medium is seen to fill dilated or cystic tubules, which are sometimes calcified. The prognosis is generally good.
In uraemic medullary cystic disease small cortical cysts are also present and these lead to progressive destruction of the nephron; this condition, characterised by thirst and polyuria, occurs in younger patients and there is often a family history. Sometimes affected patients are salt wasters which aggravates the degree of renal failure but, even when treated appropriately serious renal failure is usual.
In medullary sponge kidney the cysts are confined to the papillary collecting ducts. Affected patients, usually adults, present with pain, haematuria, stone, or urinary infection. The diagnosis is made by IVU. Contrast medium is seen to fill dilated or cystic tubules, which are sometimes calcified. The prognosis is generally good.
In uraemic medullary cystic disease small cortical cysts are also present and these lead to progressive destruction of the nephron; this condition, characterised by thirst and polyuria, occurs in younger patients and there is often a family history. Sometimes affected patients are salt wasters which aggravates the degree of renal failure but, even when treated appropriately serious renal failure is usual.
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