Ultrasound progression of prenatally detected multicystic dysplastic kidney
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Published on: June 21, 2024
Eli A Siqueira Rabelo1, Eduardo A Oliveira, Jose Maria P Silva
1Department of Pediatrics, Pediatric Nephrourology Unit, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Insights
Multicystic dysplastic kidney (MCDK) shows significant involution, with size reduction occurring most rapidly in the first 30 months of life. This natural decrease suggests conservative management is effective for prenatal MCDK.
Area of Science:
- Pediatric Nephrology
- Medical Imaging
- Developmental Biology
Background:
- Multicystic dysplastic kidney (MCDK) is a common congenital anomaly.
- Prenatal detection of MCDK allows for early monitoring.
- The natural course and involution patterns of MCDK require further elucidation.
Purpose of the Study:
- To evaluate the sonographic involution of prenatally detected multicystic dysplastic kidney (MCDK).
- To determine the rate and pattern of MCDK size reduction over time.
- To assess the correlation between MCDK involution and patient growth parameters.
Main Methods:
- Analysis of 53 children with unilateral MCDK detected prenatally.
- Conservative management with regular ultrasound follow-up for up to 68 months.
- Linear mixed-effects modeling to assess MCDK length changes relative to age and body size.
Main Results:
- 91% of MCDK cases showed partial or total sonographic involution.
- MCDK length significantly correlated negatively with patient age and body size.
- The rate of MCDK length reduction was highest in the first 30 months (0.80 mm/mo), slowing thereafter.
Conclusions:
- Prenatally detected MCDK exhibits a strong tendency for sonographic involution.
- The rate of MCDK involution is significantly faster during early childhood (first 30 months).
- Findings support conservative management strategies for prenatally diagnosed MCDK.
Objectives:
To evaluate the sonographic involution of prenatally detected multicystic dysplastic kidney (MCDK).
Methods:
A total of 53 children with unilateral MCDK detected by prenatal ultrasonography between 1989 and 2004 were included in this analysis. All children received conservative management with follow-up visits every 6 months. Follow-up ultrasound examinations were performed at 6-month intervals during the first 2 years after birth and yearly thereafter. A linear mixed effect model was constructed, including MCDK length as the dependent variable and body size parameters and contralateral renal dimensions as independent variables.
Results:
The mean follow-up time was 68 months. A total of 334 ultrasound scans were analyzed. The ultrasound scan demonstrated partial or total involution of the MCDK in 48 cases (91%). A consistent negative correlation was found among MCDK length, patient age, and body size parameters. As a whole, the MCDK length reduction was estimated to be 0.29 mm/mo. The rate of reduction was not constant over time and was intense during the first 30 months of age. According to the regression model, MCKD reduced in length by 0.80 mm/mo during the first 30 months of age, 0.26 mm between 30 and 84 months old, and 0.30 mm in children older than 84 months.
Conclusions:
Our results suggest a clear tendency of MCDK to decrease in size, with the rate of the involution greater during the first 30 months than the rate in older children.
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