Fetal Multicystic Dysplastic Kidney and Its Effect on Post-natal Quality of Life: A Literature Review

Multicystic dysplastic kidney (MCDK) is a congenital renal malformation defined by a nonfunctional kidney consisting of numerous cysts and dysplastic parenchyma. MCDK most commonly affects one kidney that follows a benign course with spontaneous involution and compensatory hypertrophy of the contralateral kidney. Recent advances in prenatal ultrasonography and genetic testing such as chromosomal microarray analysis have improved early detection and risk stratification, allowing for individualized management approaches. Current guidelines favor conservative management for simple unilateral cases, prioritizing periodic blood pressure monitoring, renal function assessment, and surveillance for rare complications; these include hypertension, urinary tract infections, and malignancy. Complex or bilateral presentations have an increased risk of chronic kidney disease and perinatal morbidity, sometimes requiring multidisciplinary management, surgical intervention, or experimental fetal therapies. Beyond clinical outcomes, MCDK management has significant psychosocial, ethical, and economic implications for affected families. This review discusses current evidence on the pathophysiology, prenatal diagnosis, management approaches, risk stratification, and long-term clinical and psychosocial outcomes associated with MCDK.