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[Multicystic renal dysplasia: changes in the contralateral urinary tract]
J A Navascues del Río1, R Luque Mialdea, J Cerdá Berrocal
1Servicio de Urología Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid.
Insights
Multicystic dysplastic kidney (MCDK) in children often presents with associated urinary tract anomalies. Early diagnosis and comprehensive evaluation are crucial for managing these complex cases.
Area of Science:
- Pediatric Nephrology
- Urology
- Medical Imaging
Context:
- Multicystic dysplastic kidney (MCDK) is a common congenital kidney malformation.
- Associated anomalies in the genitourinary tract are frequently observed in MCDK patients.
- This study reviews cases of MCDK treated over 15 years.
Purpose:
- To analyze the spectrum of associated anomalies in children with MCDK.
- To evaluate diagnostic methods and findings in MCDK cases.
- To highlight the importance of thorough urological assessment in MCDK.
Summary:
- Seven children with MCDK were evaluated, with three presenting contralateral upper urinary tract anomalies.
- Associated findings included vesicoureteral reflux, bifid pelvis, bladder diverticulum, urethral duplication, and nonobstructive hydronephrosis.
- One case demonstrated significant extra-urologic anomalies, including bowel malrotation and congenital cardiopathy.
Impact:
- Highlights the high incidence of associated anomalies in pediatric MCDK.
- Emphasizes the need for comprehensive diagnostic workup beyond the affected kidney.
- Informs clinical practice regarding the management of complex pediatric urogenital malformations.
Abstract:
We have treated seven children with multicystic dysplastic kidney during the last 15 years. Three of then presented contralateral upper urinary tract anomalies. Four cases were diagnosed during prenatal period and three during the first term of life. We did analytic kidney function evaluation, ultrasound examination, voiding cystourethrography, radionuclide scan, gammagraphy, excretory urography and urinary cultures in all cases. We have found a vesicoureteral reflux with a bifid pelvis associated in the same child and two other cases with nonobstructive hydronephrosis. The child with vesicoureteral reflux presented also ipsilateral anomalies like a bladder diverticulum and an incomplete urethral duplication. One child with hydronephrosis opposite to the multicystic dysplastic kidney, also presented a bowel malrotation and a congenital cardiopathy, as extra-urologic associated anomalies.