1 / 17

Renal Medullary Cysts

Renal Medullary Cysts. The case of Tobey Montaldo 134495. Signalment and History. 7 year old MC Golden Retriever Suspect pyelonephritis Microscopic hematuria Isosthenuria Polyuria/Polydipsia Intermittent urinary incontinence. Treatment prior to referral.

angie
Download Presentation

Renal Medullary Cysts

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Renal Medullary Cysts The case of Tobey Montaldo 134495

  2. Signalment and History • 7 year old MC Golden Retriever • Suspect pyelonephritis • Microscopic hematuria • Isosthenuria • Polyuria/Polydipsia • Intermittent urinary incontinence

  3. Treatment prior to referral For treatment of recurrent E. coli UTI • Clavamox for 10 days • Amoxicillin for 6 weeks • Cephalexin, undetermined duration

  4. Imaging • Ultrasound performed on 7/17/07: possible pyelonephritis; right renal medullary cavitations or cysts—rule out abscess or neoplasia

  5. Imaging • CT scan on 8/29/07: renal corticomedullary or medullary cavitary lesions, bilateral, solitary hepatic cyst • Renal infarcts seen, some associated with cysts

  6. Recheck Ultrasound • Recheck on 1/16/08: slight changes in sizes of cysts, persistent left pyelectasia

  7. Differential Diagnoses for Medullary or Corticomedullary Cysts • Polycystic Kidney Disease • Simple renal cortical cysts—degenerative • Neoplasia—carcinoma, sarcoma • Abscessation • Medullary Sponge Kidney?? No reports in dogs, but recognized syndrome in humans

  8. Medullary Sponge Kidney • Usually non-progressive, asymptomatic • Often found incidentally during renal imaging • Clinical signs, if present, include hematuria, UTI, or renal calculi • May have mild concentration defect or mild proteinuria • High risk of struvite or oxalate calculi • May be associated with congenital hemihypertrophy and Wilms’ tumor, but not always

  9. Medullary Sponge Kidney • Laboratory tests: urinalysis, calcium excretion (tend to be hypercalciuric), urine culture (may have UTI—urine stasis) • Imaging: excretory urography (radial, linear striations in papillae, or cystic, ectatic collecting ducts) • Ultrasound or CT useful, but probably unnecessary, as this is not a progressive dz

  10. Treatment of Humans with MSK • If hypercalciuric, thiazide diuretics • Manage any renal calculi • Treat UTIs with antibiotics • Decreased Na/Increased K intake

  11. References Ginalski J, Portmann L, Jaeger P. Does medullary sponge kidney cause nephrolithiasis? American Journal of Roentgenology 1990; 155:299-302. Rommel D, Pirson Y. Medullary sponge kidney—part of a congenital syndrome. Nephrology Dialysis Transplantation 2001; 16:634-636. Trachtman H. Medullary sponge kidney. www.emedicine.com/ped/topic1394.htm 2007.

More Related