Management and etiology of the unilateral multicystic dysplastic kidney

A review

David Hains, Carlton M. Bates, Susan Ingraham, Andrew L. Schwaderer

Research output: Contribution to journalReview article

81 Citations (Scopus)

Abstract

In children, unilateral multicystic dysplastic kidney (MCDK) is one of the most frequently identified urinary tract abnormalities. A variety of proposed etiologies has been associated with the underlying pathogenesis of MCDK. These include genetic disturbances, teratogens, in utero infections, and urinary outflow tract obstruction. From 5-43% of the time, MCDK has associated genito-urinary anomalies, both structural and functional in nature. A review of the literature reveals that involution rates are reported to be 19-73%, compensatory hypertrophy of the contralateral kidney occurs from 24-81% of the time, and estimated glomerular filtration rates (GFRs) (by the Schwartz formula) range from 86-122 ml/min per 1.73m2 body surface area. Most authors suggest serial ultrasonography to monitor contralateral growth, routine blood pressure monitoring, and a serum creatinine monitoring algorithm. The risk of hypertension in those with MCDKs does not appear to be greater than that of the general population, and the rates of malignant transformation of MCDK are small, if at all increased, in comparison with those in the general population. If the patient develops a urinary tract infection or has abnormalities of the contralateral kidney, shown on ultrasound, a voiding cystourethrogram is recommended. Finally, the body of literature does not support the routine surgical removal of MCDKs.

Original languageEnglish (US)
Pages (from-to)233-241
Number of pages9
JournalPediatric Nephrology
Volume24
Issue number2
DOIs
StatePublished - Jan 1 2009
Externally publishedYes

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Multicystic Dysplastic Kidney
Urinary Tract Infections
Teratogens
Kidney
Body Surface Area
Urinary Tract
Glomerular Filtration Rate
Hypertrophy
Population
Ultrasonography
Creatinine
Blood Pressure
Hypertension
Growth
Serum

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

Cite this

Management and etiology of the unilateral multicystic dysplastic kidney : A review. / Hains, David; Bates, Carlton M.; Ingraham, Susan; Schwaderer, Andrew L.

In: Pediatric Nephrology, Vol. 24, No. 2, 01.01.2009, p. 233-241.

Research output: Contribution to journalReview article

Hains, David ; Bates, Carlton M. ; Ingraham, Susan ; Schwaderer, Andrew L. / Management and etiology of the unilateral multicystic dysplastic kidney : A review. In: Pediatric Nephrology. 2009 ; Vol. 24, No. 2. pp. 233-241.
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