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Published on: January 12, 2019
Clinical features of children with multicystic dysplastic kidney
Aslihan Kara1, Metin Kaya Gurgoze1, Mustafa Aydin2
1Department of Pediatric Nephrology, Firat University School of Medicine, Elazig, Turkey.
Insights
Multicystic dysplastic kidney (MCDK) in children typically follows a benign clinical course with few complications. Close follow-up and conservative management are recommended for these patients.
Area of Science:
- Pediatric Nephrology
- Urology
- Medical Genetics
Background:
- Multicystic dysplastic kidney (MCDK) is a congenital anomaly characterized by non-functioning renal tissue.
- Understanding the clinical spectrum of MCDK is crucial for appropriate patient management.
Purpose of the Study:
- To evaluate the clinical features and outcomes of pediatric patients diagnosed with multicystic dysplastic kidney (MCDK).
Main Methods:
- Retrospective review of medical records for children diagnosed with MCDK between January 2008 and November 2015.
- Analysis of demographic, clinical, laboratory, and radiological data.
Main Results:
- Of 128 children with MCDK, 64.1% were male. Antenatal diagnosis occurred in 50% of cases.
- Associated urological anomalies included vesicoureteral reflux (20.8%), ureteropelvic junction obstruction (4.7%), hypospadias (0.8%), and kidney stones (0.8%).
- Hypertension was rare (0.8%), and 59.4% showed compensatory hypertrophy in the contralateral kidney. Only 5.5% required nephrectomy.
Conclusions:
- Multicystic dysplastic kidney (MCDK) generally follows a benign clinical course with minimal long-term sequelae.
- Conservative management and close monitoring are recommended for children with MCDK.
- The study highlights the low incidence of significant complications and the favorable prognosis of MCDK.
Background:
To evaluate the clinical features of patients with multicystic dysplastic kidney (MCDK).
Methods:
The medical files of children diagnosed with MCDK between January 2008 and November 2015 were retrospectively reviewed. The demographic, clinical, laboratory and radiological data were evaluated.
Results:
Of 128 children with MCDK enrolled in the study, 82 (64.1%) were male, and 46 (35.9%) were female (P < 0.05). MCDK were located on left and right sides in 66 (51.6%) and 62 children (48.4%), respectively (P > 0.05). Antenatal diagnosis was present in 64 patients (50%). The mean age at diagnosis was 2.8 ± 2.7 years (range, 0-8 years), and follow-up duration was 4.5 years. Fifteen patients (20.8%) had vesicoureteral reflux. Of these, four underwent endoscopic surgical correction. Other associated urological anomalies were ureteropelvic junction obstruction (n = 6), hypospadias (n = 1), and kidney stones (n = 1). On technetium-99 m dimercaptosuccinic acid scintigraphy, which was performed in all patients, no significant association between grade of reflux and presence of scarring was seen. Hypertension was diagnosed only in one child (0.8%) who required antihypertensive treatment. The prevalence of unilateral undescended testicle in children aged <1 year in the 82 male patients was 4.9%. Seventy-six patients (59.4%) developed compensatory hypertrophy in the contralateral kidney during a 1 year follow-up period. Of the total, only seven children (5.5%) had undergone nephrectomy.
Conclusions:
MCDK follows a benign course with relatively few sequelae, and therefore these patients should be closely followed up and conservatively managed.
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