central renal cyst vs. hydronephrosis?

16 year old FS DLH.  Mild azotemia BUN 32, creat 2.2, HCT 25% (anemia seems disproportionate to degree of azotemia).  Would you consider the left renal pelvis moderately dilated? No uroliths seen, ureter could be picked up more distally and looked normal.  Would you be thinking chronic urolith passage/fibrosis/infection? Then her right kidney has what looks like a large cyst at midline, but want to be sure you don’t think it is more of a hydronephrosis situation? Ureter fades away, no visible uroliths.  Bladder empty and normal

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