A clinician's guide to the diagnosis and management of kidney cysts.

Kidney cysts are frequently encountered as incidental findings on imaging studies and are typically benign in nature. However, certain cysts exhibit characteristics that may predispose them to malignant transformation. The Bosniak classification, based on contrast-enhanced computed tomography or magnetic resonance imaging, offers a systematic approach to stratifying kidney cysts by their radiological features and estimating the associated risk of malignancy. This classification further informs clinical decision-making regarding surveillance, intervention or referral. This review provides a comprehensive examination of the pathophysiology, epidemiology, diagnostic evaluation and referral pathways for kidney cysts, with an emphasis on the practical application of the Bosniak classification in clinical practice.