Relationship Between Simple Renal Cysts and Hypertension: A Systematic Review and Meta-Analysis

Background: Simple renal cysts (SRCs) are the most common incidentally found cystic lesions in the kidney. While their association with hypertension (HT) has been explored in various studies, the findings remain inconclusive. Thus, our meta-analysis aimed to systematically evaluate the relationship between SRCs and HT (PROSPERO ID: CRD42025580609). Methods: We conducted searches in PubMed, Web of Science Core Collection, and Scopus to identify observational studies that examined the association between SRCs and HT. All articles containing animal or pediatric (<18 years old) study populations or having <10 patients in total and/or lacking a control group that did not develop HT were excluded. Two reviewers independently screened the studies and extracted the data, and the quality of each included study was assessed using the Newcastle-Ottawa Scale. Statistical analyses were performed using Review Manager 5.4. Results: In total, 12 studies with 147,310 participants were included in this meta-analysis. Presence of SRCs was associated with a 2.04-fold higher likelihood of having HT (OR 2.04, 95%CI 1.70-2.45, p < 0.0001). Multivariate analysis further revealed that SRCs were independently associated with HT (aOR 1.36, 95%CI 1.24-1.49, p < 0.0001), with multiple SRCs (aOR 1.36, 95%CI 1.26-2.42, p = 0.0008) and bilateral SRCs (aOR 2.26, 95%CI 1.12-4.59, p = 0.02) showing a stronger association. Conclusions: This study provides the first in-depth review on the topic, showing an established link between SRCs and HT even after adjustment for major confounding factors such as age, sex, renal function, and other metabolic factors.