J Korean Pediatr Soc.  2000 Jul;43(7):926-932.

Natural History and Clinical Feature of Multicystic Dysplastic Kidney detected with Prenatal Ultrasonography

• Shin YL
• Won HS
• Yoon JH
• Park YS

Abstract

PURPOSE: Multicystic dysplastic kidney(MCDK) is characterized by the presence of multiple cysts of varying sizes. It is associated with ureteral or pelviureteral atresia, and a non-functioning kidney. The purpose of this study was to examine the clinical feature and the natural history of MCDK.
METHODS
A study was performed in 36 children with prenatal diagnosis of MCDK from 1989 to 1999. All patients underwent renal ultrasonography and scintigraphy, and most underwent voidin, cystourethrography after birth. Follow-up renal ultrasonography was performed generally every year.
RESULTS
Initial size of ultrasonography showed that MCDK was larger than normal in 27 cases, normal in 5 cases, and smaller than normal in 4 cases. Follow-up was available on 26 children during 12-78 months. In one patient, there was a complete involution of the MCDK. In 15 patients(58%), there was a reduction in size and 9 patients(35N) showed no change. One patient underwent nephrectomy for an enlarged MCDK. Voiding cystourethrography in 23 patients revealed vesicoureteral reflux in 6(26%). Other abnormalities of the contralateral kidney was detected in 3 of 36 children(8%), consisting of hydronephrosis, hydronephrosis and ureterocele, and simple cyst. Hypertrophy of the contralateral kidney was observed in 14% at birth and 50% in follow up. No renal dysfunction, hypertension and urinary tract infection were noted in all patients during follow up.
CONCLUSION
The natural history of MCDK demonstrates a low incidence of complications and a high incidence of spontaneous regression. Therefore, uncomplicated MCDK is best managed conservatively. But further long-term follow up study is needed.

Keyword

Multicystic dysplastic kidney; Prenatal ultrasonography

MeSH Terms

Child
Follow-Up Studies
Humans
Hydronephrosis
Hypertension
Hypertrophy
Incidence
Kidney
Multicystic Dysplastic Kidney*
Natural History*
Nephrectomy
Parturition
Prenatal Diagnosis
Radionuclide Imaging
Ultrasonography
Ultrasonography, Prenatal*
Ureter
Ureterocele
Urinary Tract Infections
Vesico-Ureteral Reflux