Çocuklarda böbrekte basit kist

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.

Anahtar Kelimeler:

çocuk, böbrek, basit kist

Simple renal cyst in children

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.

Keywords:

Children, kidney, simple cyst,

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