Clinical outcome of children with prenatally diagnosed isolated unilateral multicystic dysplastic kidney

Abstract

Purpose: Multicystic dysplastic kidney (MCDK) is a congenital urinary tract anomaly affecting approximately 1 in 4300 live births. The impact of unilateral MCDK on children's health during their early years, including conditions like hypertension, malignancy, urinary tract infections (UTIs), and proteinuria, is not well documented. This study aims to analyze and follow up prenatally detected cases of isolated unilateral MCDK to enhance prenatal counseling for parents.

Methods: In a retrospective analysis, children diagnosed with unilateral MCDK were followed from prenatal identification through their first years of life by analyzing their medical records.

Results: Out of 68 pregnant women with suspected MCDK, 44 children were identified in the pediatric database. Postnatal diagnosis confirmed unilateral MCDK in 31 children. The follow-up period ranged from 0 to 209 months (mean 60 months). Notably, no hypertension or malignancy was detected in any child. However, proteinuria affected 1 child (3 % of the study population), and UTIs occurred in 5 children (16 %). Involution occurred in 9 children (29 %), and nephrectomy was performed in 4 children (13 %).

Conclusion: The prognosis for isolated unilateral MCDK in children is favorable, with no hypertension or malignancy. A conservative non-operative approach is justified for disease management, providing crucial information for parents of affected unborn children.

Keywords: Hypertension; MCDK; Malignancy; Multicystic dysplastic kidney; Multicystic kidney disease; Urinary tract infections.