Document Detail


Multicystic dysplastic kidney in children--a need for conservative and long term approach.
MedLine Citation:
PMID:  19381503     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We retrospectively studied our cases of Multicystic Dysplastic Kidney (MCDK). The review was aimed at identifying the pattern of the disease in Indian Scenario and the required management thereof. METHODS: We studied the clinical, radiological and nuclear scan findings of 22 patients with unilateral MCDK. They were diagnosed and/or treated in our unit from 1999 to 2007. The diagnosis was achieved by Ultrasound and further confirmed by DMSA scans. Other ancillary investigations like Micturating cystourethrogram were done if indicated. These patients were followed and followup investigations consisted of renal ultrasound, blood pressure measurement, and urinalysis and blood biochemistry RESULTS: A total of 22 patients (18 boys and 4 girls) with unilateral MCDK were investigated and followed for a mean period of 41 months. MCDK was detected on antenatal ultrasound only in 12(55%) and postnatally in 10(45%) babies. Mean age for postnatal diagnosis was 20 months. Follow up ultrasound revealed complete involution of MCDK in 3 patients and partial regression in 11 patients. The size of dysplastic kidney was unchanged in 4 patients and a further 4 patients underwent nephrectomy. Indications of nephrectomy were parental anxiety in 2, hypertension in 1 and palpable mass in 1. CONCLUSION: Large proportion (45%) of patients in presented series are diagnosed post natally contrary to western world where more than 80% are diagnosed antenatally. Uncomplicated isolated MCDK carry good prognosis with nephrectomy required in only a few patients. Association with other urological anomalies in ipsilateral/contralateral genitourinary tract is important to identify as they have worse outcome in terms of ultimate renal function. All patients with simple/complex unilateral MCDK should be advised long term follow up for the possible development of hypertension and/or hyper infiltration injury.
Authors:
Jitendra Kumar Singh; Ravi Prakash Kanojia; K L Narasimhan
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Publication Detail:
Type:  Journal Article     Date:  2009-04-16
Journal Detail:
Title:  Indian journal of pediatrics     Volume:  76     ISSN:  0973-7693     ISO Abbreviation:  Indian J Pediatr     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-10-05     Completed Date:  2010-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417442     Medline TA:  Indian J Pediatr     Country:  India    
Other Details:
Languages:  eng     Pagination:  809-12     Citation Subset:  IM    
Affiliation:
Department of Pediatric Surgery, Advanced Pediatric Center, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Multiple / diagnosis,  epidemiology,  therapy
Diagnosis, Differential
Diagnostic Imaging
Female
Humans
India / epidemiology
Infant
Infant, Newborn
Kidney Function Tests
Male
Multicystic Dysplastic Kidney / diagnosis*,  epidemiology,  therapy
Pregnancy
Prenatal Diagnosis
Retrospective Studies

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