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The natural history of the multicystic dysplastic kidney in children
G T Rottenberg1, I Gordon, R De Bruyn
1Department of Radiology, Great Ormond Street Hospital for Children NHS Trust, London, UK.
Insights
Most multicystic kidneys shrink or disappear within two years. This study tracked kidney size using sonography, finding size at diagnosis doesn't predict this natural regression.
Area of Science:
- Pediatric Nephrology
- Medical Imaging
- Developmental Biology
Background:
- Multicystic dysplastic kidney (MCDK) is a common congenital anomaly.
- Understanding its natural history is crucial for clinical management.
- Sonography is the primary imaging modality for diagnosis and follow-up.
Purpose of the Study:
- To investigate the natural history of multicystic dysplastic kidney.
- To evaluate the efficacy of sonography in monitoring MCDK changes over time.
Main Methods:
- Retrospective analysis of 66 children with radiological diagnosis of MCDK.
- Sonographic assessment of kidney size changes over a median follow-up of 32 months.
- Correlation of initial kidney size with eventual outcome.
Main Results:
- 55 children had adequate follow-up data.
- 40/55 (73%) MCDKs showed size reduction, with 22 becoming undetectable by ultrasound.
- Reduction in size occurred by a mean age of 84 weeks.
- 10/55 kidneys increased in size, and 5/55 remained unchanged.
Conclusions:
- Multicystic dysplastic kidneys typically undergo partial or complete involution within the first two years of life.
- Sonography is effective for monitoring MCDK regression.
- Initial kidney size is not a reliable predictor of the long-term outcome.
Abstract:
The objective of this study was to examine the natural history of the multicystic dysplastic kidney and the use of sonography for follow-up studies. A retrospective study was performed on 66 children with a radiological diagnosis of multicystic kidney. The change in size demonstrated on sonograms was examined. Adequate follow-up was available on 55 children over a period of 32 months (range 2-69 months). 40/55 of the kidneys underwent a reduction in size, including 22 which were no longer detectable by ultrasound. 10/55 kidneys showed an increase in size and 5/55 showed no change. Reduction in size occurred at a mean age of 84 weeks (range 20-120 weeks). In conclusion, most multicystic kidneys undergo partial or complete involution over the first 2 years of life. The mean size of the multicystic kidney at diagnosis is a poor predictor of eventual outcome.