Natural History and Clinical Feature of Multicystic Dysplastic Kidney detected with Prenatal Ultrasonography.
- Author:
Young Lim SHIN
1
;
Hye Sung WON
;
Jong Hyun YOON
;
Young Seo PARK
Author Information
1. Department of Pediatrics, College of Medicine, University of Ulsan, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Multicystic dysplastic kidney;
Prenatal ultrasonography
- MeSH:
Child;
Follow-Up Studies;
Humans;
Hydronephrosis;
Hypertension;
Hypertrophy;
Incidence;
Kidney;
Multicystic Dysplastic Kidney*;
Natural History*;
Nephrectomy;
Parturition;
Prenatal Diagnosis;
Radionuclide Imaging;
Ultrasonography;
Ultrasonography, Prenatal*;
Ureter;
Ureterocele;
Urinary Tract Infections;
Vesico-Ureteral Reflux
- From:Journal of the Korean Pediatric Society
2000;43(7):926-932
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Multicystic dysplastic kidney(MCDK) is characterized by the presence of multiple cysts of varying sizes. It is associated with ureteral or pelviureteral atresia, and a non-functioning kidney. The purpose of this study was to examine the clinical feature and the natural history of MCDK. METHODS: A study was performed in 36 children with prenatal diagnosis of MCDK from 1989 to 1999. All patients underwent renal ultrasonography and scintigraphy, and most underwent voidin, cystourethrography after birth. Follow-up renal ultrasonography was performed generally every year. RESULTS: Initial size of ultrasonography showed that MCDK was larger than normal in 27 cases, normal in 5 cases, and smaller than normal in 4 cases. Follow-up was available on 26 children during 12-78 months. In one patient, there was a complete involution of the MCDK. In 15 patients(58%), there was a reduction in size and 9 patients(35N) showed no change. One patient underwent nephrectomy for an enlarged MCDK. Voiding cystourethrography in 23 patients revealed vesicoureteral reflux in 6(26%). Other abnormalities of the contralateral kidney was detected in 3 of 36 children(8%), consisting of hydronephrosis, hydronephrosis and ureterocele, and simple cyst. Hypertrophy of the contralateral kidney was observed in 14% at birth and 50% in follow up. No renal dysfunction, hypertension and urinary tract infection were noted in all patients during follow up. CONCLUSION: The natural history of MCDK demonstrates a low incidence of complications and a high incidence of spontaneous regression. Therefore, uncomplicated MCDK is best managed conservatively. But further long-term follow up study is needed.
