Multicystic dysplastic kidney: diagnosis and evolution

Rahman, Ricardo C.; Amoreo, Oscar

doi:10.1007/s00467-005-1865-1

Cited by 10 publications

(8 citation statements)

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“…Aslam et al reported that complete involution rate was 33% over 24 months, 47% over 60 months, and 59% ove 120 months [3]. Rabelo et al noted that the mean time of complete involution was 122 months in their study group, but the rate of involution was higher during the first 30 months of age than in older patients [33,37]. MCDK completely involuted in 39.3% of our study group within 48 months, and the dysplastic tissue persisted in 60.7%.…”

Section: Discussionmentioning

confidence: 86%

“…Therefore, some authors advocate that VCUG should be performed in all patients with MCDK to determine contralateral VUR [25,34,38]. According to other authors, routine VCUG was not necessary, because VUR was usually low grade when US assessment was normal [3,31,32,37,39]. Ismaili et al suggested that clinically significant contralateral anomalies could be ruled out by two successive normal renal US performed at the third day and at the end of the first month of life [40].…”

Section: Discussionmentioning

confidence: 99%

“…Other authors suggested conservative follow-up with blood pressure measurement and US examination, because MCDK often undergoes involution, and complications such as malignant transformation and hypertension are rare [3,23,25,[31][32][33][34][35][36][37]. Malignant transformation has been reported to be very rare [1,2,[16][17][18].…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Unilateral multicystic dysplastic kidney: single-center experience

Kıyak¹,

Yılmaz²,

Turhan³

et al. 2009

Pediatr Nephrol

View full text Add to dashboard Cite

show abstract

“…Another study of 30 patients with MCDK reported a VUR incidence of 17% [23]. Ultimately, the rates of VUR in patients with MCDK range from 5% to 43% [21,22,[24][25][26][27][28][29]. While the reported incidence of VUR in patients with MCDK is quite variable, most studies find that the vast majority of affected individuals have low grades of reflux (grades I or II), ranging from 47% to 96% [21,25,27].…”

Section: Vesicoureteral Refluxmentioning

confidence: 99%

“…Ureteropelvic junction (UPJ) obstruction has been described in 7-15% of individuals with MCDKs [29,30]. Ureterovesical junction (UVJ) obstruction is also reported in up to 6% of patients with MCDKs [30].…”

Section: Obstructionmentioning

confidence: 99%

Management and etiology of the unilateral multicystic dysplastic kidney: a review

et al. 2009

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In children, unilateral multicystic dysplastic kidney (MCDK) is one of the most frequently identified urinary tract abnormalities. A variety of proposed etiologies has been associated with the underlying pathogenesis of MCDK. These include genetic disturbances, teratogens, in utero infections, and urinary outflow tract obstruction. From 5-43% of the time, MCDK has associated genito-urinary anomalies, both structural and functional in nature. A review of the literature reveals that involution rates are reported to be 19-73%, compensatory hypertrophy of the contralateral kidney occurs from 24-81% of the time, and estimated glomerular filtration rates (GFRs) (by the Schwartz formula) range from 86-122 ml/min per 1.73 m(2) body surface area. Most authors suggest serial ultrasonography to monitor contralateral growth, routine blood pressure monitoring, and a serum creatinine monitoring algorithm. The risk of hypertension in those with MCDKs does not appear to be greater than that of the general population, and the rates of malignant transformation of MCDK are small, if at all increased, in comparison with those in the general population. If the patient develops a urinary tract infection or has abnormalities of the contralateral kidney, shown on ultrasound, a voiding cystourethrogram is recommended. Finally, the body of literature does not support the routine surgical removal of MCDKs.

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Outcome of children with multicystic dysplastic kidney: Does involved side matter?

Yavuz,

Kıyak,

Sander

2023

Birth Defects Research

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BackgroundMulticystic dysplastic kidney (MCDK) is a common anomaly detected on antenatal ultrasound. We aimed to assess the profile of children with MCDK and to investigate whether the involved side has any effect on outcome.MethodsThirty‐nine patients with MCDK and 20 controls were enrolled. Patients who estimated glomerular filtration rate (eGFR) values over 90 mL/min/1.73 m2 were compared with controls. Comparison was made between the involved sides.ResultsMKDB was right‐sided in 20 (51.3%) and left‐sided in 19 (48.7%) patients. 33.3% had additional urinary tract abnormality, 10.2% had systemic abnormality. 82% showed contralateral kidney enlargement. 48.7% involuted, 17.9% underwent nephrectomy. 35.8% suffered from urinary tract infection (UTI). 5.1% had renal scarring (RS). 30% developed microalbuminuria. 12.8% complicated with hypertension. 17.9% progressed to chronic kidney disease (CKD). Hypertension was independent risk factor for developing CKD. Blood pressure, cystatin C and urine microalbumin/creatinine levels were increased, and eGFR values were decreased in patients compared to controls. No significant difference was found between the two sides for rates of involution, UTI, RS, nephrectomy, and additional abnormality. Cystatin C levels were higher on the right than left sides (p = .033).ConclusionChildren with MCDK predispose to renal deterioration even at normal eGFR values. Although cystatin C levels tended to increase in right‐sided patients, the involved side seemed to have no significant effect on renal outcome. Hypertension was main determinant for progression to CKD in MCDK.

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Multicystic dysplastic kidney: diagnosis and evolution

Cited by 10 publications

References 1 publication

Unilateral multicystic dysplastic kidney: single-center experience

Unilateral multicystic dysplastic kidney: single-center experience

Management and etiology of the unilateral multicystic dysplastic kidney: a review

Outcome of children with multicystic dysplastic kidney: Does involved side matter?

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