Multicystic dysplastic kidneys (MCDK) during prenatal life and postnatal outcome

Multicystic dysplastic kidneys (MCDK) are commonly detected on prenatal ultrasound examinations, occurring in 1 in 1,000 to 4,300 live births. This study focuses on neonatal outcomes in fetuses with MCDK, with particular attention to the presence of additional anomalies.

Retrospective data of fetuses diagnosed with MCDK at Charité University Hospital between 2005 and 2022 were collected and analyzed. Rates of termination of pregnancy (TOP), intrauterine fetal demise (IUFD) and live birth were evaluated. Outcome parameters, including APGAR score, survival, neonatal ventilation therapy or respiratory adjustment disorder, were examined.

A total of 103 fetuses with MCDK were identified. Eight exhibited bilateral MCDK (7.8%). 92.2% showed unilateral MCDK (n = 95), of which 43 revealed additional anomalies (45.3%). Fetuses with additional anomalies displayed significantly fewer live births, more prematurity, lower APGAR scores and lower gestational ages at birth. The expected outcome of fetuses with MCDK is contingent upon the presence of additional anomalies. Bilateral MCDK, as well as unilateral MCDK with additional anomalies, are associated with an unfavorable postnatal outcome.

To consult parents on the potential postnatal well-being of their offspring with MCDK, it is crucial to search for additional anomalies. Genetic counseling and invasive genetic testing should be offered.