Skip to main content
SpringerLink
Log in

Multicystic dysplastic kidney: our experience in non-surgical management

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Introduction

Although multicystic dysplastic kidney (MDK) is a common renal anomaly, the management of this condition remains controversial. The purpose of this study was to focus on its regression by ultrasound (US) scan for MDK managed conservatively.

Materials and methods

Between 1990 and 2010, 50 children with MDK were retrospectively studied. All patients were submitted to radioisotope scan to confirm the diagnosis, and a micturating cystogram to exclude other uropathies.

Results

Of the 50 patients, 19 underwent nephrectomy, and the other 31 were conservatively managed with clinical and US scan follow-up. The mean follow-up time (range 6 months to 11 years) in the non-operated group was 6.2 years. Of the 31 children with nonsurgical management, 17 (54.8%) showed total involution on US scan, 7 (22.6%) showed a partial regression, and 7 (22.6%) were unchanged at the time of this study. The mean time to complete disappearance on US scan was 2.5 years (1–4 years). No children developed hypertension or tumors.

Discussion

The natural history of MDK is usually benign, but patients must have long-term follow-up with US scan. In addition, many studies confirmed that the disappearance of it on a US scan does not mean a total involution of the affected kidney. We recommend a strict follow-up even when US scan shows an undetectable kidney.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Gordon AC, Thomas DFM, Arthur RJ, Irving HC (1988) Multicystic dysplastic kidney: is nephrectomy still appropriate? J Urol 140:1231–1234

    PubMed  CAS  Google Scholar 

  2. Eckoldt F, Woderich R, Smith RD, Heling KS (2004) Antenatal diagnostic aspects of unilateral multicystic kidney dysplasia– sensitivity, specificity, predictive values, differential diagnoses, associated malformations and consequences. Fetal Diagn Ther 19:163–169

    Article  PubMed  Google Scholar 

  3. Rickwood AMK, Anderson PAM, Williams PL (1992) Multicystic renal dysplasia detected by prenatal ultrasonography. Natural history and results of conservative management. Br J Urol 69:538–540

    Article  PubMed  CAS  Google Scholar 

  4. Narchi H (2005) Risk of hypertension with multicystic kidney disease: a systematic review. Arch Dis Child 90:921–924

    Article  PubMed  CAS  Google Scholar 

  5. Narchi H (2005) Risk of Wilms’ tumour multicystic kidney disease: a systematic review. Arch Dis Child 90:147–149

    Article  PubMed  CAS  Google Scholar 

  6. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114:555–576

    Article  Google Scholar 

  7. Aslam M, Watson AR, On behalf of the Trent, Anglia MCDK Study Group (2006) Unilateral multicystic dysplastic kidney: long term outcomes. Arch Dis Child 91:820–823

    Article  PubMed  CAS  Google Scholar 

  8. Rabelo EAS, Oliveira EA, Diniz JSS, Silva JMP et al (2004) Natural history of multicystic kidney conservatively managed: a prospective study. Pediatr Nephrol 19:1102–1107

    Article  PubMed  Google Scholar 

  9. Oliveira EA, Diniz JSS, Vilasboas AS, Rabelo EAS, Silva JMP, Filgueiras MTF (2001) Multicystic dysplastic kidney detected by foetal sonography: conservative management and follow-up. Pediatr Surg Int 17:54–57

    Article  PubMed  CAS  Google Scholar 

  10. Homsy YL, Anderson JH, Oudjhane K, Russo P (1997) Wilms’ tumor and multicystic dysplastic kidney disease. J Urol 158:2256–2260

    Article  PubMed  CAS  Google Scholar 

  11. Weinstein A, Goodman T Rob, Iragorri S (2008) Simple multicystic dysplastic kidney disease: end points for subspecialty follow-up. Pediatr Nephrol 23:111–116

    Article  PubMed  Google Scholar 

  12. Webb NJA, Lewis MA, Bruce J, Gough DCS, Ladusans EJ, Thomson APJ, Postlethwaite RJ (1997) Unilateral multicystic dysplastic kidney: the case for nephrectomy. Arch Dis Child 76:31–34

    Article  PubMed  CAS  Google Scholar 

  13. Tilemis S, Savanelli A, Baltogiannis D, Cigliano B, Settimi A (2003) Is the risk of hypertension an indication for prophylactic nephrectomy in patients with unilateral multicystic dysplastic kidney? Scand J Urol Nephrol. 37(5):429–432

    Article  PubMed  CAS  Google Scholar 

  14. Seeman T, John U, Blàhovà K, Vondrichova H, Janda J, Misselwitz J (2001) Ambulatory blood pressure monitoring in children with unilateral multicystic dysplastic kidney. Eur J Pediatr 160:78–83

    Article  PubMed  CAS  Google Scholar 

  15. Luque-Mialdea R, Martìn-Crespo R, Cebrian J, Moreno L, Carrero C, Fernandez A (2007) Does the multicystic dysplastic kidney really involute? The role of the retroperitoneoscopic approach. J Pediatr Urol 3:48–52

    Article  PubMed  CAS  Google Scholar 

  16. Cambio AJ, Evans CP, Kurzrock EA (2008) Non-surgical management of multicystic dysplastic kidney. BJU Int 101:804–808

    Article  PubMed  Google Scholar 

  17. Kaneko K, Kun W, Yamakata A, Othomo Y, Yamashiro Y, Miyano T (2000) Is nephrectomy for neonatal multicystic dysplastic kidney still inappropriate? Nephron 86:376–377

    Article  PubMed  CAS  Google Scholar 

  18. Cochat P (1994) La dysplasie rénal multi kystique: étude multicentrique. Ann Pèdiatr 41:24–31

    Google Scholar 

  19. Hains DS, Bates CM, Ingraham S, Schwaderer AL (2009) Management and etiology of the unilateral multicystic dysplastic kidney: a review. Pediatr Nephrol 24(2):233–241

    Article  PubMed  Google Scholar 

  20. Wacksman J, Phipps L (1993) Report of the Multicystic Kidney Registry: preliminary findings. J Urol 150:1870–1872

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Pediatric Surgery, Department of Pediatrics, University “Federico II”, Naples, Italy

    Aurelie Chiappinelli, Antonio Savanelli, Alessandra Farina & Alessandro Settimi

Authors
  1. Aurelie Chiappinelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Antonio Savanelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alessandra Farina
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alessandro Settimi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Aurelie Chiappinelli.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chiappinelli, A., Savanelli, A., Farina, A. et al. Multicystic dysplastic kidney: our experience in non-surgical management. Pediatr Surg Int 27, 775–779 (2011). https://doi.org/10.1007/s00383-011-2910-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-011-2910-8

Keywords

Search

Navigation