All issues > Volume 43(7); 2000

Original Article

J Korean Pediatr Soc. 2000;43(7):926-932. Published online July 15, 2000.

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

Young Lim YL Shin¹, Hye Sung HS Won², Jong Hyun JH Yoon³, Young Seo YS Park¹

¹Departments of Pediatrics, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
²Departments of Obstetrics, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
³Departments of Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea

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 voiding 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(35%) 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 were 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.

Keywords :Multicystic dysplastic kidney, Prenatal ultrasonography