Polycystic kidneys, renal hamartomas, their variants and complications

In polycystic renal disease, the cysts progressively increase in size, destroying the surrounding renal tissue. The cysts may become very large. Not only may renal failure ensue but haemorrhage and infection may also lead to serious complications. Occasionally the condition may be complicated or mimicked by hamartomas or neoplasms. Hamartomas may be single or multiple, and are most commonly multiple in tuberose sclerosis, giving an appearance on pyelograms similar to polycystic kidney. Their presence may sometimes be suspected on plain radiographs by their high fat content. Nephrotomograms during the nephrogram phase of high dose urography will demonstrate the defects in the nephrogram due to the cysts or more solid masses. Angiograms, if performed, will show defects in the nephrograms more clearly and may show abnormal vascularity, hamartomas having characteristic ‘beaded’ vessels. Cysts or tumours may also be present in the liver and pancreas.