Solitary cyst of the left or right kidney: ICD-10 code, causes, symptoms, treatment

Solitary renal cyst

Solitary cysts can occur in different parts of the body, not only in the kidneys. The very name “solitary” means that the cyst is large and single. Most often, a single solitary cyst forms in the kidneys, but two neoplasms may also appear.

In rare cases, doctors diagnose almost symmetrical cysts - on each kidney. When making a diagnosis, the doctor must note which kidney cyst he is dealing with - right and left. Most often, the tumor is found in the left organ, and victims of the disease are men after 55-60 years of age.

A cyst itself is a cavity in an organ, formed by its walls and filled with some liquid or other contents. A solitary cyst is called simple: it has thin walls, and there are no partitions or separate chambers inside.

The classic shape is round or oblong. The contents of the cystic cavity are lymph or clear serous fluid (it is secreted by the serous membranes of organs).

ICD-10 (full name - International Statistical Classification of Diseases and Related Health Problems) classifies renal solitary cyst as a disease of the genitourinary system. The ICD-10 code is N28.1, acquired cyst. For a single congenital cyst the code is Q61.0.

Solitary renal cyst

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Symptoms of the disease

Symptoms of stones in children differ little from those in adults, but renal colic is less common at an early age.

Kidney stones can only be accurately diagnosed through a medical examination - blood and urine tests, ultrasound, x-rays or MRI.

But various symptoms will presumably help identify kidney stones:

intermittent urination;
burning and pain when urinating;
renal colic - pain in the lumbar region;
increased body temperature and nausea (rather rare symptoms);
bright yellow sediment or blood in the urine;
high blood pressure;
pain in the genitals and lower abdomen;
excretion of stones or sand with urine.

Stones appear mainly in one kidney, less often both are affected. The localization of renal colic also depends on this: the pain is concentrated either on one side or along the entire lower back.

Sometimes pain is felt in the hips, tailbone and genitals. This symptom rarely occurs in children. They often suspect the disease based on pronounced sediment in the urine.

Children who cannot speak become whiny and touch their genitals and stomach. In this case, it is necessary to consult a doctor as soon as possible and undergo all the necessary tests.

Blood comes out in the urine mainly in the presence of sharp crystalline stones. They cut the kidney walls with their edges, so the blood comes out.

In advanced cases, the wounded surfaces become infected and begin to rot. Then you can see pus in the urine.

It is worth knowing that if kidney stones are not treated in a timely manner, the affected organ can suffer severe damage and even stop functioning altogether.

Causes of the disease

The main cause of kidney stones is considered to be metabolic disorders.

But there are many factors that can lead to these disorders, which subsequently cause an increase in the concentration of mineral salts in the kidneys:

poor nutrition;
increased calcium content in food;
bone diseases;
insufficient water intake;
congenital pathologies of the genitourinary system;
bacterial infections;
drinking too hard water with a high content of mineral salts;
hot climate;
narrowing of the ureter;
sedentary lifestyle;
heredity;
excessive alcohol consumption;
frequent use of diuretics.

Frequent consumption of too salty, fried and fatty foods can lead to nephrolithiasis.

The children's body is very sensitive to harmful substances in food, so doctors and nutritionists recommend maintaining a separate diet for babies.

This applies not only to the prevention of urolithiasis, but also to the health of the entire body.

Lack of fluid in the body leads to an increase in the concentration of salts in the kidneys, which then turn into stones. A hot climate causes the disease according to the same principle: water leaves the body through sweat.

Physical inactivity, or lack of activity, is also a cause of pathology. Sedentary children have problems with joints and bones.

As a result, calcium is removed from the bones into the blood and urine, and its increased content in the kidneys can lead to the formation of stones.

This is why excess calcium is harmful for children, especially in combination with low mobility.

Some diseases of the genitourinary system prevent the timely outflow of urine, which causes harmful substances and salts to accumulate in the kidneys. These later form into stones.

Diuretics, on the contrary, remove too much fluid. After them, the body becomes dehydrated, and the kidneys cannot fully dilute and remove salts. Diarrhea causes the same symptoms.

It should be remembered that if parents or grandparents have kidney stones, the child also has a chance of getting this disease.

Treatment of the disease

If kidney stones are detected in a child, under no circumstances should you treat yourself. This can only be done by a qualified doctor.

Stones up to 10 mm can be removed from the body with the help of medications. The child is prescribed a special diet, sufficient fluid intake and, if necessary, pain medication.

The time of such treatment depends on the stage of the disease.

Surgery is required if the stones are large enough, cause persistent pain, or interfere with the flow of urine.

Today, there are several gentle surgical techniques. This is especially important for children, as they are very sensitive to anesthesia and severe pain.

One such technique is the destruction of stones by laser or ultrasound shock waves. The stone, turned into sand, leaves the body in urine within a few days.

Another method is to insert a special endoscope into the kidney through a small incision in the skin. The rarest and most traumatic method is classic open surgery.

Angiomyolipoma of the kidney, ICD code 10

Kidney tumors were first described in the 19th century. Since then, many theories of the occurrence of the disease have been proposed. It was believed that carcinogens, sex hormones, and radiation influence the appearance of cancer. There is currently no consensus regarding the etiology of the disease.

Prevalence

Men suffer from neoplastic processes of the kidney more than twice as often as women. In the system of tumors of the urinary tract, lesions of the upper sections are in third place after malignant lesions of the prostate gland (C61) and bladder (C67). Among oncological diseases, kidney tumors account for 3%.

International classification

ICD-10 divides all diseases into groups. Each pathology, including tumors, is designated by a Latin letter and a digital code. This formulation will be understood anywhere in the world.

Regarding kidney cancer, the following groups and their ICD codes can be distinguished:

C64 - malignant neoplasm localized within the kidney,
C65 - malignant tumors of the renal pelvis.

Both ICD-10 diagnoses belong to the “neoplasms” class, the “malignant tumors” section. At the same time, the C64 code completely excludes the disease localized in the pelvis and calyces.

Stages

According to the worldwide TNM classification, the following stages of kidney cancer (C64) are distinguished:

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If the primary formation cannot be assessed, it is designated with an “x”
when there are no signs of a tumor, then it is conventionally defined by the symbol “0”,
T1 - the detected neoplasm is located within the urinary organ and does not exceed 7 cm,
T2 - tumor more than 7 cm in size, limited to the kidney,
T3 - kidney cancer has spread to one of the following anatomical parts: adrenal gland, veins, surrounding tissues,
T3(a) - damage only to the overlying adrenal gland or perinephric tissue,
T3(b) - involvement of the renal or inferior vena cava under the diaphragm,
T3(c) - tumor spread over the diaphragmatic dome,

N (from Latin nodi lymphatici) - condition of regional lymph nodes

Nx - it is impossible to assess the condition of the lymph nodes,
N0 - absence of metastasis,
N1 - damage to one lymph node,
N2 - involvement of more than two lymph nodes in the process,

M (metastasis) - presence of distant metastases

Mx - lack of reliable data on the presence of distant metastasis,
M0 - not found,
M1 - distant metastases were found.

Using this classification of kidney cancer according to the ICD greatly simplifies the diagnosis for doctors and gives direction regarding treatment.

Symptoms of malignant neoplasm

All symptoms caused by kidney cancer are characterized by stages. Thus, in the first stages of development of the pathology, patients complain only of blood in the urine (55%) and weakness (76%).

In this case, the blood is determined in the form of “worms”, since during its passage through the urinary tract it coagulates and takes on a unique shape. In 29% of cases of diagnosed kidney cancer, patients noted a sharp sudden increase in body temperature.

At the second stage, patients complained of similar symptoms.

In 100% of cases, patients at the third stage of the disease had severe weakness. 30% of men were diagnosed with varicocele, 20% of patients suffered from high blood pressure. At this stage there was pain in the lumbar region (59%).

As the disease progresses, symptoms worsen. As the kidney tumor increases in size, it can be felt during a physical examination.

The following changes are detected in the laboratory:

anemia,
decrease in the amount of protein in the blood,
acceleration of ESR,
the appearance of red blood cells in the urine,
increased activity of certain enzymes (LDH, ALT, PME-1).

Most cases of detection of kidney tumors occur by chance during examination for other pathologies. At the same time, subjectively, patients do not note any changes in their well-being.

Diagnostics

The basis for diagnosing a kidney tumor is instrumental examination methods. The simplest and most accessible is ultrasound scanning of the retroperitoneal space. During an ultrasound, it is possible to detect a volumetric formation of the kidneys and evaluate parameters such as:

size and structure of the tumor,
deformation of the contour of the renal capsule,
the presence of foci of hemorrhage and necrosis,
the state of blood flow in the formation and the organ itself,
accompanying changes in the urinary tract.

Other methods of examining oncological patients include CT, MRI, excretory urography, and renal angiography. They allow you to assess the functional ability of an organ and identify even small tumors.

The last stage of the examination is a biopsy. As a rule, the diagnosis is made based on minimally invasive methods, and histology is performed after the neoplastic lesion has been removed.

Treatment of malignant kidney tumors

The main treatment method is radical nephrectomy (removal of the organ). It can be performed using various accesses. This method of treatment allows you to completely remove the cancer and prevent its further spread.

Sometimes tumor resection is performed. Such cases include:

bilateral kidney cancer (ICD-10 code also C64),
the only spare kidney
carefully selected patients,
dysfunction of the contralateral organ,
refusal of the patient or his guardians from radical treatment.

If the tumor has affected distant lymph nodes (ICD stage - 4, M1), immunotherapy with interferons is performed. To ensure that the patient receives palliative treatment, a nephrectomy is performed.

The role of chemotherapy and radiation therapy in the treatment of malignant kidney tumors (C64) is minimal. Therefore, they are practically not used. There are no specific methods for preventing the disease.

Source: https://1pochki-med.ru/pochki/obrazovanie-levoj-pochki-kod-po-mkb/

Causes

Although kidney cysts are a fairly well-studied disease, doctors have still not been able to give an unambiguous answer as to why solitary cysts appear. Today, there are 2 main theories on this matter, according to which solitary neoplasms are divided into 2 types: acquired and congenital.

You can find different statistical data on what type of renal cyst occurs most often: some sources claim that the ratio is equal, others generally give the palm to congenital neoplasms. But small studies, often conducted in large Russian hospitals, report that the majority of patients with this diagnosis are over 50 years old and men. That is, the cyst in these cases is acquired.

Congenital cystic formation, according to scientists, occurs if during the mother’s pregnancy the baby’s kidneys and ureters do not form correctly. More precisely, the primordia of some renal tubules are incorrectly connected to the outflow canals.

An acquired anomaly is formed when urine stagnates in the renal tubules, the fluid presses on the walls from the inside, and they begin to protrude.

This phenomenon occurs against the background of various diseases:

after kidney injury;
with urolithiasis (stones provoke stagnation of urine);
for kidney infections;
with inflammation (for example, pyelonephritis);
due to cancer.

Features of the disease and causes

According to the international classification, there are two forms of polycystic disease:

autosomal dominant;
autosomal recessive.

The disease is considered hereditary and manifests itself in both sexes to the same extent. Genetic pathologies usually appear over the age of 45 years.

It is worth considering a number of factors that aggravate the course of the disease:

smoking;
drinking coffee.

The disease is much more severe in men.

Symptoms

A solitary renal cyst can range in size from a few millimeters to 10 cm. A small neoplasm can be completely asymptomatic; some patients live with such a cyst for many years and are not even aware of its presence.

But if the cystic vesicle grows, then when it reaches a certain size it begins to put pressure on neighboring tissues and bring noticeable discomfort to the person.

The following symptoms occur:

heaviness and aching pain in the side, from the cystic kidney;
cloudy urine color (when fluid stagnates);
high blood pressure (renal hypertension);
reduced amount of urine or its complete absence;
blood in the urine (the most dangerous symptom).

If an infection is added to the solitary cyst, then the renal pain and colic intensify and spread to the abdominal area. The patient's temperature rises and he gets chills. Moreover, the symptoms do not depend on which kidney the solitary cyst is “settled” on – on the right and left. The size of the cystic formation, the presence of infections, concomitant diseases, etc. are important.

Chronic renal failure with a solitary cyst develops extremely rarely, but some of its signs can be observed in patients with a large cyst. These are thirst, dry mouth, increased amount of urine (polyuria).

Types of disease

Symptoms of angiomyolipoma appear the same for the left and right kidneys and depend on concomitant pathologies and mutations in the affected organ.

With a single isolated neoplasm, the patient feels the following:

Pain on the side of the abdomen. Depends on which kidney is affected by the disease.
On palpation of the peritoneum, swelling is detected.
When urinating, blood is detected.

Vascular-muscular lipoma takes a long time to develop and does not cause health problems. When the tumor size exceeds 4 cm, secondary changes occur in the parenchyma. Kidney functions are impaired. The patient experiences certain symptoms:

Pulling pain in the peritoneum;
Loss of body weight;
Arterial hypertension;
Increased fatigue;
Lethargy.

Symptoms do not appear suddenly. Unpleasant sensations continue to grow for a long time. From the abdominal area the pain spreads to the side and lower back. The patient notes pressure surges. Hypertension is life-threatening because the tonometer readings reach high numbers. Back pain is often confused with osteochondrosis, so the patient does not see a doctor until his health suddenly deteriorates. The first trip to the hospital among most patients occurs after the appearance of blood in the urine.

If nothing is done about the tumor, the symptoms increase and complications develop. There are hemorrhages in the organ and in the surrounding space. When a tumor ruptures, the patient experiences:

Acute pain;
Feeling of fear;
Nausea accompanied by vomiting;
Paleness of the skin;
Coldness in the extremities;
A sharp decrease in temperature;
The pressure drops sharply and rapidly decreases;
There is weakness;
Fainting;
Urine filtering stops;
Liver and heart failure develops;
Brain functions are impaired, consciousness becomes confused.

There is a danger of developing peritonitis; a burst organ requires emergency surgery. With total damage, sometimes it is necessary to remove the kidney.

Diagnostics

A routine examination, medical history and laboratory methods will not help the doctor identify a solitary cyst. Sometimes, upon palpation, a tumor is felt on the side of the kidney, but in this case the neoplasm does not always turn out to be a cyst.

Therefore, the main methods for diagnosing solitary kidney cysts are instrumental:

Ultrasonography.
Tomography of the kidney.
Excretory urography.

Often, a cystic formation is detected by chance when an ultrasound scan is performed for other indications. On ultrasound, a solitary cyst has the following signs:

smooth rounded shape, thin walls that are clearly visible against the background of the renal cortex;
in the place where the cyst connects to the kidney parenchyma, an acute angle can be recognized - the so-called beak symptom;
the cyst pushes aside the renal calyces that make up the pelvis. Sometimes it compresses the pelvis itself.

Differential diagnosis is important when it is necessary to distinguish a solitary renal cyst from malignant neoplasms. In this case, excretory urography in combination with nephrotomography is indispensable; an x-ray is also taken and the cyst is punctured. That is, the study of serous contents.

Solitary renal cyst on sonogram

1 - normal kidney tissue; 2- cyst.

Renal polycystic disease during pregnancy and newborns

To avoid the possibility of such a disease in the fetus, a woman should carefully plan her conception. Before pregnancy begins, it is necessary to cure all acute and infectious diseases, and also undergo an examination by a geneticist to identify possible risks of the disease in the fetus.

During pregnancy, a woman should be examined by ultrasound at least 3 times to identify possible pathology in the early stages and prevent its development.

If the examination reveals multicystic disease or bilateral kidney damage, then this disease is incompatible with life. With this diagnosis, termination of pregnancy is indicated even at a long term. Modern medicine detects pathology in the early stages, which makes it possible to control the course of the disease and prevent its progression.

Treatment

In many cases, a solitary cyst grows to a certain size and stops without causing any inconvenience or causing complications. Therefore, if the renal cyst does not exceed 20 mm, doctors use a wait-and-see approach. The patient is not prescribed any special treatment; an ultrasound and urine tests are performed once a year, and specialists ensure that the cyst does not begin to grow.

If the cystic formation is associated with infection, antibiotic therapy is necessary.

When the cystic formation grows more than 2 cm, doctors may recommend puncture with drainage. In this case, fluid is pumped out of the cyst, and then sclerosing drugs are injected, which seem to glue it together from the inside.

In severe cases, surgery is required: laparoscopic or conventional.

The main indications for surgical intervention for a diagnosis of “solitary renal cyst” are:

severe lumbar pain;
impaired urine output (small volume, cloudy color, etc.);
cyst size is more than 4 cm;
there is a possibility of developing cancer.

After the autopsy, the doctor must evaluate the condition of the organ and see if there are any malignant changes. Depending on this, the patient may have to undergo kidney removal, resection, excision of cystic walls, or enucleation of the neoplasm itself.

How to treat polycystic kidney disease?

There are two types of traditional treatment: conservative and surgical.

Conservative treatment

Drug therapy is aimed at relieving symptoms of the disease and treating complications.

to lower blood pressure .
Eliminating anemia involves prescribing iron supplements and vitamin complexes.
To treat pyelonephritis, antibiotics and uroseptics (fluoroquinolones, nitrofuran derivatives, cephalosporins) are used.

Surgery

Surgery is indicated for rapid growth of closed cysts and their suppuration. The cavities of the cysts are opened and emptied.

In the event of the development of the last stage of renal failure, patients are connected to an “artificial kidney” apparatus. A complex system of filters cleanses the blood of metabolic products and excess fluid. The radical method of treating the disease is transplantation .

Folk remedies

Treatment with folk remedies for polycystic disease can be carried out after consultation with the attending physician. Alternative medicine methods can only be used against the background of basic drug therapy.

The chaga mushroom has the ability to slow down the abnormal division of renal epithelial cells and maintain the functional activity of healthy tissue. It is recommended to drink chaga in the form of a decoction or infusion prepared from pure dried raw materials.

Medicinal plants

For polycystic kidney disease, you can drink decoctions based on calendula, chamomile, celandine, burdock root, and shepherd's purse. These plants relieve spasms of the urinary tract, kill bacteria, and improve metabolism.

Perga

Beebread is used to treat diseases associated with excessive cell proliferation, which include polycystic kidney disease. Also this beekeeping product:

has an antimicrobial effect;
normalizes blood pressure;
helps increase hemoglobin.

Forecasts

Traditionally, urologists classify a solitary cyst as a safe neoplasm - the prognosis for such a diagnosis is quite favorable; the cyst rarely degenerates into a malignant tumor.

If it does not increase in size and there are no indications for surgery, then the patient can live calmly with this diagnosis and not worry: a solitary renal cyst has absolutely no effect on the quality of life.

But when the cystic vesicle begins to grow, there is a risk of dangerous complications:

Rupture of a solitary cyst.
Infection and suppuration inside the cyst.
Chronic pyelonephritis.
Uremia (poisoning of the body with toxic products of protein metabolism).
Degeneration of a simple cyst into a malignant tumor (sometimes the tumor develops directly in the cystic cavity or “grows” from its wall).
Chronic renal failure.

Since the exact causes of the appearance of a solitary cyst have not been identified, there are also no methods for preventing this disease. But we can reduce the risk of developing kidney disease: protect ourselves from hypothermia, treat infections in a timely manner, avoid injuries and eat right.

Experimental treatments[edit | edit code]

Although there is no clinically tested effective treatment, all over the world there is an active search for drugs aimed at slowing the growth of cysts and inhibiting the development of renal failure specific to polycystic disease.

In clinical trials involving humans, drugs whose effect is associated with a decrease in the accumulation of cyclic adenosine monophosphate in cells (somatostatin analogues, vasopressin V2 receptor antagonists, mTOR inhibitors) are actively being studied.

There are also a number of drugs that have been studied only in laboratory animals. In particular, O. Yu. Beskrovnaya showed in laboratory mice the possibility of blocking the development of PBP by inhibiting cyclin-dependent kinases (that is, stopping the proliferation of the cyst epithelium)[6], as well as inhibiting the synthesis of glycosylceramide[12].