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MCDK not excluded by virtue of function on renal scan
P D Metcalfe1, J R Wright, P A M Anderson
1Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada.
The Canadian Journal of Urology
|January 9, 2003
Summary
Advances in renal scans reveal minimal function in multicystic dysplastic kidneys (MCDK), challenging the traditional view. This finding impacts the diagnosis and management of MCDK in pediatric patients.
Area of Science:
- Pediatric Nephrology
- Diagnostic Imaging
- Renal Pathology
Background:
- Conservative management of multicystic dysplastic kidneys (MCDK) is effective, aided by improved diagnostic imaging.
- MCDK is classically a non-functioning renal mass.
- Increased renal scan sensitivity detects function in MCDK previously missed.
Purpose of the Study:
- To report cases of MCDK exhibiting function on renal scans.
- To evaluate the implications of detected renal function in MCDK.
Main Methods:
- Retrospective review of eight pediatric cases with MCDK.
- Analysis of renal scan findings and follow-up data.
- Histopathological correlation for nephrectomy cases.
Main Results:
- Eight cases of MCDK with detectable renal function on scans were identified.
- Four patients underwent nephrectomy; histology confirmed MCDK.
- Four patients were managed conservatively with successful radiographic involution and no complications.
Conclusions:
- Minimal renal function on nuclear scintigraphy does not exclude an MCDK diagnosis.
- This finding refines the understanding of MCDK characteristics.
- Conservative management can be considered even with minimal detected renal function.