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Abnormal contralateral kidney in unilateral multicystic dysplastic kidney disease
1Department of Pediatrics, Juntendo University School of Medicine, Tokyo, Japan.
Insights
Infants with unilateral multicystic dysplastic kidney (MCDK) often have associated urinary tract abnormalities, most commonly contralateral vesicoureteral reflux (VUR). Early diagnosis and treatment of VUR can prevent recurrent infections.
Area of Science:
- Pediatric Urology
- Nephrology
- Medical Imaging
Background:
- Multicystic dysplastic kidney (MCDK) is a congenital condition affecting kidney development.
- Associated urological anomalies can impact patient outcomes.
- Prenatal diagnosis via ultrasonography is increasingly common.
Purpose of the Study:
- To investigate urological abnormalities associated with unilateral MCDK in infants.
- To identify the prevalence and types of these associated anomalies.
- To analyze findings from voiding cystourethrography (VCUG).
Main Methods:
- Retrospective study of seven infants diagnosed with unilateral MCDK.
- Review of patient records, focusing on urological abnormalities.
- Analysis of VCUG results to assess contralateral and ipsilateral anomalies.
Main Results:
- 57% of patients (4 out of 7) had urological abnormalities beyond MCDK.
- Contralateral vesicoureteral reflux (VUR) was the most frequent associated anomaly (3 patients).
- Other anomalies included an ipsilateral ectopic ureter and an ipsilateral ureterocele.
Conclusions:
- Contralateral VUR is a significant associated finding in unilateral MCDK.
- Early detection and management of VUR, including anti-reflux surgery, can be effective.
- Prompt surgical intervention for high-grade VUR prevented recurrent urinary tract infections in treated infants.
Abstract:
We performed a retrospective study of infants with unilateral multicystic dysplastic kidney (MCDK) in order to investigate the associated urological abnormalities. We examined the records of seven patients, in five of whom a diagnosis had been made prenatally using ultrasonography. Our investigation focused on the associated urological abnormalities, particularly on the contralateral side, and the results of voiding cystourethrography (VCUG). Four of the seven patients (57%) had urological abnormalities other than MCDK: three exhibited vesicoureteral reflux (VUR) of the contralateral side including one patient who also had an ipsilateral ectopic ureter, and the fourth patient had a ureterocele of the ipsilateral side. The results indicate that contralateral VUR, was the most common abnormality associated with MCDK. Two infants had high-grade VUR and underwent anti-reflux surgery soon after the diagnosis. Both have remained free of recurrent urinary tract infection.