The Outcome of Multicystic Dysplastic Kidney Disease Patients at King Abdulaziz Medical City in Riyadh

Abstract

BackgroundMulticystic dysplastic kidney (MCDK) is a type of kidney dysplasia consisting of many irregular, varioussized cysts divided by dysplastic renal tissue, which negatively impacts kidney function. MCDK is one of the most common renal congenital disorders seen in antenatal ultrasounds. The typical prognosis of MCDK is complete or partial involution that starts antenatally and continues postnatally. The aim of the study was to shed light on the overall outcome of patients with MCDK. MethodsWe retrospectively collected data on MCDK patients from 2016 until 2022 at King Abdulaziz Medical City, Ministry of National Guard Health Affairs in Saudi Arabia, Riyadh. The data included the recording of epidemiological data, radiological and laboratory reports, and the presence of urological or non-urologically associated anomalies. ResultsA total of 57 patients with MCDK were reviewed. Seven of them were excluded due to the diagnosis of bilateral MCDK, which was incompatible with life. Of the remaining 50 patients, the right kidney was affected in 52% of them. Most patients were diagnosed antenatally (98%). The mean duration of follow-up for the study was 48 months. Vesicoureteral reflux (VUR) was detected in 22% of the total sample. Overall, 90% of the patients underwent kidney involution. A small percentage had genitourinary anomalies (20%), while a larger percentage (48%) had extrarenal abnormalities. ConclusionMulticystic dysplastic kidney disease is relatively common in children. The prognosis is affected by the presence of genitourinary and non-genitourinary anomalies. Patients have an overall good prognosis with conservative management. Antenatal screening, diagnosis, and long-term nephrological follow-up are essential for the optimal management of patients.

Characteristics and outcome of children with unilateral multicystic dysplastic kidney disease in Upper Egypt

“…The previous literature showed variable findings regarding the side of involvement. (5,6,(11)(12)(13) In our series, most of cases (74.3%) were identified antenatal via an ultrasound examination. This rate is comparable with the previous studies.…”

“…(16) In contrast to our results, Alamir et al stated that the vast majority (90%) of their cohort showed some degree of involution at a longer follow up period than ours. (13) The previous studies showed that initial MCDK length is the most important factor for predicting complete involution. (22) Hayes et al reported that the involution rates were significantly higher in patients with initial MCDK of <5 cm.…”

“…VUR of the contralateral kidney is the most common among them. (6,11,13,16) Kopac et al reported that about 43.8% of patients with MCDK had associated urogenital anomalies, cryptorchidism (24%) and VUR (16.3%) of the contralateral kidney were the most common among them. (11) Dogan et al found that one in three patients with MCDK had associated urogenital malformations with VUR of the contralateral kidney (26.6%) being the most common.…”

“…Similarly, Alamir et al did not observe hypertension in any of their study cohort that included 50 patients. (13) The incidence of hypertension with MCDK is very low and ranges from 0.6 to 17.7% in the literature. (9,20) Hypertension is usually related to abnormalities in the contralateral kidney.…”

Single-Center Experience of Pediatric Cystic Kidney Disease and Literature Review

“…Genetic testing is still far from being a part of a regular clinical workup, both in developed and developing countries [4,[61][62][63][64][65]. Therefore, describing the clinical and laboratory findings and outcomes in patients with CyKD can still provide important and valuable information for clinical practice [66]. Nevertheless, due to population genetic and environmental epigenetic influences, single-center cohort studies cannot be generalized [67].…”