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Multicystic dysplastic kidney 1/2000 Common cause of abdominal mass in newborn Contralateral VUR:15% Contralateral hydronephrosis:5-10%

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Presentation on theme: "Multicystic dysplastic kidney 1/2000 Common cause of abdominal mass in newborn Contralateral VUR:15% Contralateral hydronephrosis:5-10%"— Presentation transcript:

1 Multicystic dysplastic kidney 1/2000 Common cause of abdominal mass in newborn Contralateral VUR:15% Contralateral hydronephrosis:5-10%

2 Sonography: kidney replaced by multiple cyst of varying size, no communication, no identifiable parenchyma. Renal scan: no function Annual followed up Nephrectomy: abdominal mass, any cyst enlarged, hypertension, stromal core increased in size

3 Multicystic dysplastic kidney Simple Complex: combined with other GU abnormality (duplication of the collecting system, dilation of the ureter or renal pevis, posterior urethral valve, neurogenic bladder, uretocele, cryptorchism)

4 Simple MCDK had an incidence of UTI similar to in children without MCDK(5%) Complex MCDK : increased risk of UTI: 28% Bilateral or unilateral MCDK with associated GU abnormality place the patietn at the incrased risk of UTI independent of VUR Clinical course and outcome for children with MCDK, Pedriatr Nephrol(2000)

5 Eur J Pediatr(1998) Multicystic kidney shrink in the first 2 years of life Contralateral kidney maintain a normal renal function as a consequence of progressive compensatory hypertrophy

6 Clinical feature of unilateral MCKD in child Eur J Pediatr(1998) 40/204: nephrectomy 164/204; conservative tx Slight renal function impairement No difference in the number of complication in two group.

7 Prophylaxis antibiotics? simpleComplex Total p ’ t2114 F/U mean(yr)5.48.4 range(yr)0.1-221.9-23 VCUG53 VUR42 Prophylaxis ABx 2(10%)7(50%)

8 outcome simpleComplex Total p ’ t2114 UTI14 Chronic renal insuficiency 04 ESRD03


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