The Turkish Journal of Pediatrics
2014 , Vol 56 , Num 1
Unilateral multicystic dysplastic kidney in children
1Division of Pediatric Nephrology, Department of Pediatrics and 2Department of Radiology, Şanlıurfa Children’s Hospital,
Şanlıurfa, Turkey. E-mail: d.caglaserpil@yahoo.com
This study was performed to evaluate the clinical course and renal outcome
of patients with unilateral multicystic dysplastic kidney (MCDK). We
retrospectively reviewed the medical records of 59 cases with MCDK followed
at Şanlıurfa Children’s Hospital between January 2009 and February 2013. The
median age of the patients (boys 52.5%) was 31 months (range: 6-197) and
the median follow-up period was 23 months (range: 6-111). Forty-two (71.2%)
patients were diagnosed antenatally. The MCDKs were found more often on
the right side (55.9%). The most frequently associated urological abnormality
was contralateral vesicoureteral reflux (VUR) (26.6%). A total of 3 (5%)
patients developed chronic renal insufficiency (CRI), 2 of whom had grade
IV and V VUR; the other patient with CRI had a small and hyperechogenic
contralateral kidney, suggesting dysplasia-hypoplasia, without any urological
anomalies on imaging studies. The size of MCDK was unchanged in 20 (34%),
had regressed in 26 (44%), and had increased in 9 (15.3%) patients. Total
involution was documented in 4 (6.7%) patients. Compensatory hypertrophy
occurred in 36/45 (80%) patients, with a mean age of 19.2±8.3 months.
Proteinuria and hypertension were detected in 1 (1.7 %) patient each.
In conclusion, abnormalities in the contralateral kidney in patients with MCDK increase the risk of renal failure. An initial investigation for associated urinary tract malformations should be done and the growth and function of the contralateral kidney, hypertension, and proteinuria should be monitored in all children with MCDK.
Keywords : multicystic dysplastic kidney, urinary tract abnormalities, renal failure.