Ambulatory blood pressure monitoring in children with unilateral multicystic dysplastic kidney

Seeman, Tomáš; John, U; Bláhová, Květa; Vondrichová, H; Janda, Jan; Misselwitz, Joachim

doi:10.1007/s004310000579

Cited by 51 publications

(24 citation statements)

References 22 publications

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“…Malignant transformation [1,2,[16][17][18] and hypertension [1,2,[19][20][21][22] associated with MCDK have been reported in the literature. Routine nephrectomy was performed in many centers to prevent those complications before 1990.…”

Section: Introductionmentioning

confidence: 99%

Unilateral multicystic dysplastic kidney: single-center experience

Kıyak¹,

Yılmaz²,

Turhan³

et al. 2009

Pediatr Nephrol

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Multicystic dysplastic kidney (MCDK) is one of the most common renal abnormalities in children. The aim of our study was to evaluate the clinical course and outcome of patients with MCDK. Ninety pediatric patients with unilateral MCDK followed by the Pediatric Nephrology Department of Bakirkoy Maternity and Children's Hospital between 1990 and 2007 were included in this retrospective study. The dimercaptosuccinic acid radionuclide scan revealed no function in MCDK in all of our patients. Voiding cystourethrogram was performed in all patients. Twenty patients (22.2%) had abnormalities in the contralateral kidney. Nephrectomy was performed in 41 patients (45.5%). Twelve patients had undergone routine nephrectomy before 1996. Since then, patients have been followed up conservatively, and nephrectomy has been performed only when indicated. Indication of nephrectomy was arterial hypertension in 16 patients (23.1%), recurrent urinary tract infection (UTI) in 11 (15.9%), and severe abdominal pain in two (2.8%). Hypertension was noted within the first year of life in all patients except two. MCDK completely involuted in 39.3% within 48 months. There was no malignant transformation, proteinuria, or renal failure. In conclusion, hypertension is often noticed in infants with MCDK. Uninephrectomy leads to normalization. However, prospective studies are needed to exclude a spontaneous improvement of hypertension.

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Section: Introductionmentioning

confidence: 99%

Unilateral multicystic dysplastic kidney: single-center experience

Kıyak¹,

Yılmaz²,

Turhan³

et al. 2009

Pediatr Nephrol

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“…Mei-Zahav et al [11] have reported that the systolic, but not the diastolic, ambulatory BP is higher in children with URA in comparison with healthy children. However, we have shown in our previous study done in children with a solitary kidney due to a contralateral multicystic dysplastic kidney [14] that the main risk factor for hypertension in these patients seems to be a structural damage of the solitary kidney, such as renal scarring, reflux, or obstructive uropathy.…”

Section: Introductionmentioning

confidence: 99%

Blood Pressure, Renal Function, and Proteinuria in Children with Unilateral Renal Agenesis

Seeman

Patzer

John

et al. 2006

Kidney Blood Press Res

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Background/Aim: Unilateral renal agenesis (URA) is a model for a reduced nephron number that is believed to be a risk factor for blood pressure (BP) elevation and reduced renal function. The aim of the study was to investigate BP and renal function in children with URA. Methods: Data on children with URA from two pediatric nephrology centers were firstly retrospectively reviewed (renal ultrasound and scintigraphy, clinical BP, creatinine clearance, urinalysis). Children with normal renal ultrasound and scintigraphy were thereafter investigated using ambulatory BP monitoring. Results: Twenty-nine children with URA were investigated – 14 children with an abnormal kidney (mostly scarring) and 15 children with healthy kidneys. Hypertension was diagnosed on the basis of clinical BP in 57% of the children with abnormal kidneys and on the basis of ambulatory BP monitoring in 1 child (7%) with healthy kidneys. The mean ambulatory BP in children with normal kidneys was not significantly different from that in controls. Forty-three percent of the children with abnormal kidneys had a reduced renal function, but none of children with normal kidneys. Conclusions: Children with abnormalities of a solitary kidney have often hypertension, proteinuria, or a reduced renal function. In contrast, children with healthy solitary kidneys have BP and renal function similar to those of healthy children.

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“…Compared to the general population there is no clinically significant increased risk of hypertension. The incidence of hypertension has been reported to be 0.5% to 14.4% in the MCDK population (12)(13)(14)(15) . In our study population, the rate of hypertension (16.6%) was found to be higher than the expected rates (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Long-Term outcome of multicystic dysplastic kidneys: A single center experience.

Can¹,

Sarıtaş²,

Alparslan³

et al. 2017

Terh

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Objective: Multicystic dysplastic kidney (MCDK) is one of the most common developmental anomalies of the kidney with an incidence of approximately 1 in 4300 live births. The goal of our study was to review our follow-up procedure of children with MCDK through this study via comparison of outcomes with the literature. Methods: Follow-up outcomes of 36 pediatric patients with antenatally detected unilateral MCDK were assessed. Results: The compensatory renal hypertrophy of the contralateral kidney was seen in 94.4% of the patients and mean complete involution time was 22.97±32.63 months. Four patients underwent nephrectomy because of hypertension resistant to medication in 2 patients and parental concern in 2 patients. Vesicoureteral reflux (VUR) was the most frequent anomaly detected in 5 (13.8%) patients. VUR were low grade in all patients and any scar was not detected on DMSA. Conclusion:The results of our study showed that MCDK is usually a benign disease. Ultrasound is a noninvasive and cost-effective method of choice in follow-up. A VCUG may not be routinely required in MCDK patients unless renal US reveals signs of suspect VUR or renal parenchymal defects.Keywords: Multicystic dysplastic kidney, nephrectomy, hypertension, complete involution, urological anomalies ÖZ Amaç: Multikistik displastik böbrek (MKDB), böbreğin en sık görülen gelişimsel anomalilerinden birisidir. Yaklaşık olarak 4300 canlı doğumda bir görülmektedir. Çalışmamızın amacı, MKDB'li çocukların takip prosedürünün mevcut sonuçlarımızı literatür ile karşılaştırılması yoluyla gözden geçirmektir. Yöntem: Antenatal tanılı MKDB'li 36 çocuk hastanın izlem sonuçları değerlendi-rildi. Bulgular: Hastaların %94,4'ünde karşı taraf böbrekte kompanzatris hipertrofi görüldü. Tam involüsyon süresi ortalama 22,97±32,63 ay idi. İkisi ilaç tedavisine dirençli hipertansiyon ve 2'si ebeveyn endişesi nedeniyle olmak üzere 4 hastaya nefrektomi yapıldı. Vezikoüreteral reflü (VUR) en sık görülen anomali olarak saptandı. Beş (%13,8) hastada VUR saptandı. Saptanan VUR tüm olgularda düşük dereceliydi ve DMSA'da skar saptanmadı. Sonuç: Çalışmamızın sonuçlarına göre MKDB genellikle iyi huylu bir hastalıktır. Ultrasonografi hastaların izleminde yeğlenebilecek girişimsel olmayan ve maliyet etkin bir yöntemdir. Ultrasonografi bulguları renal parenkimal defekt ve şüpheli VUR bulguları göstermedikçe rutin VCUG yapılması gerekmeyebilir.

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Ambulatory blood pressure monitoring in children with unilateral multicystic dysplastic kidney

Cited by 51 publications

References 22 publications

Unilateral multicystic dysplastic kidney: single-center experience

Unilateral multicystic dysplastic kidney: single-center experience

Blood Pressure, Renal Function, and Proteinuria in Children with Unilateral Renal Agenesis

Long-Term outcome of multicystic dysplastic kidneys: A single center experience.

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