Differential Diagnosis

• Single most likely diagnosis
  • Benign nephrosclerosis or Multicystic Kidney Disease: This diagnosis is likely due to the presence of multiple simple cysts in both kidneys, which is a common finding in multicystic kidney disease. The small nonobstructing bilateral nephrolithiasis may be an incidental finding.
• Other Likely diagnoses
  • Autosomal Dominant Polycystic Kidney Disease (ADPKD): Although the presence of multiple simple cysts in both kidneys could suggest ADPKD, the absence of hydronephrosis and the small size of the nephrolithiasis make this diagnosis less likely. However, it is still a possible diagnosis, especially if there is a family history.
  • Medullary Sponge Kidney: This condition is characterized by the presence of small cysts and nephrolithiasis, which fits the patient's presentation. However, it is less common than multicystic kidney disease.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Renal Cell Carcinoma: Although the cysts are described as simple, it is essential to rule out renal cell carcinoma, especially if there are any suspicious features on imaging. A missed diagnosis of renal cell carcinoma could be deadly.
  • Tuberous Sclerosis Complex: This genetic disorder can cause renal cysts and nephrolithiasis, and it is essential to consider it in the differential diagnosis, especially if there are other systemic symptoms.
• Rare diagnoses
  • Von Hippel-Lindau Disease: This rare genetic disorder can cause renal cysts and nephrolithiasis, as well as other systemic symptoms. Although it is unlikely, it should be considered in the differential diagnosis, especially if there are other suspicious findings.
  • Primary Hyperoxaluria: This rare genetic disorder can cause nephrolithiasis and renal cysts, and it is essential to consider it in the differential diagnosis, especially if there are other systemic symptoms.