Abstract
Simple multicystic dysplastic kidney (MCDK) disease, defined as unilateral MCDK without other genitourinary tract involvement, portends an excellent prognosis. Nevertheless, its long-term management remains undefined. This study aims to provide subspecialty discharge recommendations for these patients. We identified eighty patients with simple MCDK disease by renal ultrasound between 1996 and 2006. Their charts were reviewed for growth of the contralateral kidney, involution of the MCDK, and incidence of complications, specifically hypertension, chronic renal insufficiency (CRI), urinary tract infection (UTI), and malignancy. Mean follow-up was 5 years. At approximately 1 year, 59% of unaffected kidneys were hypertrophied (≥95th percentile for age/ height) and 100% were >50th percentile. With continued follow-up, 80.3% of unaffected kidneys were hypertrophied. Likewise, at 1 year, 71.2% of MCDKs assessed were either involuting or had disappeared; on further follow-up, this increased to 89.6%. No patient had hypertension, CRI, or malignancy. Four patients (5%) developed nonrecurrent UTIs, none leading to renal scarring or growth impairment. These data suggest that subspecialty follow-up may be discontinued once contralateral hypertrophy and ipsilateral involution occur, assuming that the patient has not experienced hypertension, CRI, or UTI. These criteria are often met by 1 year of age, which would preclude repeated visits, uncomfortable investigations, and unnecessary costs.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 111-116 |
| Number of pages | 6 |
| Journal | Pediatric Nephrology |
| Volume | 23 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2008 |
| Externally published | Yes |
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Keywords
- MCDK involution
- Multicystic dysplastic kidney (MCDK)
- Prognosis
- Simple MCDK
- Single kidney compensatory hypertrophy
- Treatment
- Unilateral cystic kidney
ASJC Scopus subject areas
- Nephrology
- Pediatrics, Perinatology, and Child Health
Cite this
Simple multicystic dysplastic kidney disease : End points for subspecialty follow-up. / Weinstein, Adam; Goodman, T. Rob; Iragorri, Sandra.
In: Pediatric Nephrology, Vol. 23, No. 1, 01.2008, p. 111-116.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Simple multicystic dysplastic kidney disease
T2 - End points for subspecialty follow-up
AU - Weinstein, Adam
AU - Goodman, T. Rob
AU - Iragorri, Sandra
PY - 2008/1
Y1 - 2008/1
N2 - Simple multicystic dysplastic kidney (MCDK) disease, defined as unilateral MCDK without other genitourinary tract involvement, portends an excellent prognosis. Nevertheless, its long-term management remains undefined. This study aims to provide subspecialty discharge recommendations for these patients. We identified eighty patients with simple MCDK disease by renal ultrasound between 1996 and 2006. Their charts were reviewed for growth of the contralateral kidney, involution of the MCDK, and incidence of complications, specifically hypertension, chronic renal insufficiency (CRI), urinary tract infection (UTI), and malignancy. Mean follow-up was 5 years. At approximately 1 year, 59% of unaffected kidneys were hypertrophied (≥95th percentile for age/ height) and 100% were >50th percentile. With continued follow-up, 80.3% of unaffected kidneys were hypertrophied. Likewise, at 1 year, 71.2% of MCDKs assessed were either involuting or had disappeared; on further follow-up, this increased to 89.6%. No patient had hypertension, CRI, or malignancy. Four patients (5%) developed nonrecurrent UTIs, none leading to renal scarring or growth impairment. These data suggest that subspecialty follow-up may be discontinued once contralateral hypertrophy and ipsilateral involution occur, assuming that the patient has not experienced hypertension, CRI, or UTI. These criteria are often met by 1 year of age, which would preclude repeated visits, uncomfortable investigations, and unnecessary costs.
AB - Simple multicystic dysplastic kidney (MCDK) disease, defined as unilateral MCDK without other genitourinary tract involvement, portends an excellent prognosis. Nevertheless, its long-term management remains undefined. This study aims to provide subspecialty discharge recommendations for these patients. We identified eighty patients with simple MCDK disease by renal ultrasound between 1996 and 2006. Their charts were reviewed for growth of the contralateral kidney, involution of the MCDK, and incidence of complications, specifically hypertension, chronic renal insufficiency (CRI), urinary tract infection (UTI), and malignancy. Mean follow-up was 5 years. At approximately 1 year, 59% of unaffected kidneys were hypertrophied (≥95th percentile for age/ height) and 100% were >50th percentile. With continued follow-up, 80.3% of unaffected kidneys were hypertrophied. Likewise, at 1 year, 71.2% of MCDKs assessed were either involuting or had disappeared; on further follow-up, this increased to 89.6%. No patient had hypertension, CRI, or malignancy. Four patients (5%) developed nonrecurrent UTIs, none leading to renal scarring or growth impairment. These data suggest that subspecialty follow-up may be discontinued once contralateral hypertrophy and ipsilateral involution occur, assuming that the patient has not experienced hypertension, CRI, or UTI. These criteria are often met by 1 year of age, which would preclude repeated visits, uncomfortable investigations, and unnecessary costs.
KW - MCDK involution
KW - Multicystic dysplastic kidney (MCDK)
KW - Prognosis
KW - Simple MCDK
KW - Single kidney compensatory hypertrophy
KW - Treatment
KW - Unilateral cystic kidney
UR - http://www.scopus.com/inward/record.url?scp=37049001233&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=37049001233&partnerID=8YFLogxK
U2 - 10.1007/s00467-007-0635-7
DO - 10.1007/s00467-007-0635-7
M3 - Article
VL - 23
SP - 111
EP - 116
JO - Pediatric Nephrology
JF - Pediatric Nephrology
SN - 0931-041X
IS - 1
ER -