Unilateral multicystic dysplastic kidney: Antenatal diagnosis and postnatal management
Nazile Ertürk
Muğla Sıtkı Koçman Üniversitesi Tıp Fakültesi Çocuk Cerrahisi Anabilim Dalı, Muğla
Keywords: Multicystic dysplastic kidney, vesicoureteral reflux, prenatal diagnosis, children
Abstract
Aim: The aim of the present study was to evaluate the results of patients diagnosed with unilateral multicystic dysplastic kidney (MCDK) in antenatal period.
Material and Methods: 15 children diagnosed with MCDK using ultrasonography between January 2007-December 2012 were included in the present study. The time of diagnosis, postnatal course of disease, additional anomaly rates and rates of urinary tract infection and antibiotic use were evaluated retrospectively. Diagnoses were confirmed with ultrasonography in postnatal period as well. All patients underwent Tc-99m mercaptoacetyltriglycine (MAG 3), 2 patients Tc-99m dimercaptosuccinic acid (DMSA) and 7 patients voiding cystourethrography investigation. The duration of follow up was between 25 and 72 months.
Results: The diagnosis of MCDK was made on mean 22. week of pregnancy with antenatal USG. The ratio of females to males was 4/11. Four of them were located on right and 11 on left side. MCDK disappeared within 4 years in 7 (46.6%) patients. In one patient, (6.6%) kidney became 10% smaller. Hypertension and malignancy occurred in none of the patients. In one patients (6.6%), 2. degree vesicoureteral reflux (VUR) was detected on contralateral side. In one patient, symptomatic urinary system infection occurred. Renal scar was seen in none of the patients.
Conclusion: Many MCDK regress or disappear in time. Postnatal detailed urological and nephrological investigations should be carried out. Asymptomatic patients may be followed conservatively. In symptomatic patients, treatment should be planned according to clinical, laboratory and radiological findings. USG may be used safely in identifying unilateral MCDK and contralateral kidney and urinary system malformations.