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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Should cortical cysts in kidneys be treated reduce serum creatinine?

My father (Aged 75 years, patient with high BP since last 30 years) was diagonised suffering from GRADE 3 Prostatomegaly (after carrying out ultrasound test + CT Scan).



Also, Gross PVR with Chronic Cystitis was the impression given in these reports. (Pre void - 2547 cc PVR - 1498)



Serum creatinine in blood was found around 4.5 mg/dl.



Since last 4 weeks, he is with Foley's bulb (initially for evacuating the urine blocked).



Now, after 4 weeks,

Serum creatinine is found reduced to 2.1 mg/dl.

potassium - 4.3 mmo/lSodium - 148 mmo/l





As per latest ultra sound report (after 4 weeks):

-Grade 3 Prostatomegaly with Chronic Cysts

-Bilateral Moderate Hydrourteronephrosis

-Bilateral Renal Cortical Cysts



Other aspects:

-Right Kidney: Moderate dilatation pelvicaliceal system and ureter noted. Cortical Cyst in upper pole measuring 3.7 x 3.0 cm.

-Left Kidney : Moderate dilatation pelvicaliceal system and ureter noted. Cortical Cyst in upper pole measuring 2.5 x 2.1 cm.

-Urinary bladder : Gross mucosal thickening noted.

-Prostrate: Enlarged in size with normal echogenisity. Weight - 180 gms.



My queries are:



- Are the Cortical Cysts in Kidneys need to be treated to further reduce serum creatinine to normal level ?



- (Note: He is strictly following diet - low sodium, low potassium + medicine for BP changed + Blocked urine emptied in last 4 weeks). No back pain, No pain near hip.... complaint,



- Still, is it recommended to have Foley's bulb/tube for 3 to 4 weeks ?

- Can enlarged prostrate can be shrinked using medicines for improving lower urinary tract /passage ? (Note: As per my father, even 4 weeks back, he is releasing urine freely - not aware that some amount blocked inside itself) - no inflammation etc -



-How to improve bladder distended bladder (thickned walls) ? Any medicines recommended at this stage ?



Kindly suggest.









-
Thu, 5 Nov 2015
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Urologist 's  Response
Hello
Thanks for query .based on the all the reports of your father I would state that your father has
1) Chronic renal failure due to bladder outlet obstruction due to grossly enlarged prostate with significant post void urine residue .

Management in such cases is as follow
1) Let the bladder be drained by Foley catheter till his creatinine levels drop down to near normal suggesting normal kidney function .
2) Continuous drainage of the bladder will help to improve bladder tone
3) Once his creatinine level drop down to near normal his enlarged prostate has to be removed either by laser prostatectomy or by open surgery depending upon the opinion of urologist .
4) Normally thickening of bladder wall does not regress to normal and there is no treatment for the same .
5) As regards treatment for renal cortical cysts they are congenital in origin and have nothing to do with renal function and do not need to be treated .

Consult qualified Urologist for evaluation and follow up his advise regarding further treatment .

Dr.Patil.
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