| Natural History and Clinical Feature of Multicystic Dysplastic Kidney detected with Prenatal Ultrasonography |
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Young Lim Shin1, Hye Sung Won2, Jong Hyun Yoon3, Young Seo 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 |
| 산전 초음파로 진단된 다낭포성 신이형성증의 임상소견 및 자연경과 |
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신영림1, 원혜성2, 윤종현3, 박영서1 |
1울산대학교 의과대학 소아과학교실,
2울산대학교 의과대학 산부인과교실
3울산대학교 의과대학 진단방사선과교실 |
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| 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. |
| Key Words:
Multicystic dysplastic kidney, Prenatal ultrasonography |
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