Long-term risk of chronic kidney disease in unilateral multicystic dysplastic kidney

Omer Mansoor, Jayanthi Chandar, Maria Rodriguez, Carolyn Abitbol, Wacharee Seeherunvong, Michael Freundlich, Gaston E Zilleruelo

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

The clinical spectrum of renal dysplasia includes the non-functioning multicystic dysplastic kidney (MCDK). We report our experience of the outcome of unilateral MCDK and its contralateral kidney in 101 children with the diagnosis of MCDK from 1985 to 2009. Data collected included urine protein/creatinine ratio, estimated GFR (eGFR), blood pressure, surgical intervention, renal length and abnormalities of the contralateral kidney, and the involution rate. There was a predominance of left-sided MCDK. Diagnosis was made prenatally in 86.7%. Contralateral abnormalities included vesicoureteral reflux (16.8%), UPJ obstruction (4.1%), and megaureter (2.4%). Complete involution of MCDK occurred within 5 years in 60%. Compensatory hypertrophy of the contralateral kidney to >97% occurred in 74.1%. Nephrectomy was performed in 19.8%. There was an increased risk of chronic kidney disease (CKD) stage 2, and hypertension in those with contralateral abnormalities (p=0.0001; p=0.001 respectively). In those without contralateral abnormalities, hyperfiltration with mean eGFR of 149±13 ml/min/1.73 m2 was seen in 32% and proteinuria in 9.8%. There was a significantly inverse relationship between proteinuria and eGFR (p=0.0001). In conclusion, children with contralateral abnormalities are at risk for developing decreased kidney function, whereas a substantial number of patients with no obvious contralateral abnormalities have markers of renal injury. Therefore, systematic follow-up of all patients is recommended.

Original languageEnglish
Pages (from-to)597-603
Number of pages7
JournalPediatric Nephrology
Volume26
Issue number4
DOIs
StatePublished - Apr 1 2011

Fingerprint

Multicystic Dysplastic Kidney
Chronic Renal Insufficiency
Kidney
Proteinuria
Vesico-Ureteral Reflux
Nephrectomy
Hypertrophy
Creatinine
Urine
Blood Pressure
Hypertension
Wounds and Injuries

Keywords

  • CKD
  • Contralateral kidney
  • Hyperfiltration
  • Multicystic dysplastic kidney
  • Non-obstructive renal dysplasia
  • Obstructive renal dysplasia

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

Cite this

Long-term risk of chronic kidney disease in unilateral multicystic dysplastic kidney. / Mansoor, Omer; Chandar, Jayanthi; Rodriguez, Maria; Abitbol, Carolyn; Seeherunvong, Wacharee; Freundlich, Michael; Zilleruelo, Gaston E.

In: Pediatric Nephrology, Vol. 26, No. 4, 01.04.2011, p. 597-603.

Research output: Contribution to journalArticle

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AB - The clinical spectrum of renal dysplasia includes the non-functioning multicystic dysplastic kidney (MCDK). We report our experience of the outcome of unilateral MCDK and its contralateral kidney in 101 children with the diagnosis of MCDK from 1985 to 2009. Data collected included urine protein/creatinine ratio, estimated GFR (eGFR), blood pressure, surgical intervention, renal length and abnormalities of the contralateral kidney, and the involution rate. There was a predominance of left-sided MCDK. Diagnosis was made prenatally in 86.7%. Contralateral abnormalities included vesicoureteral reflux (16.8%), UPJ obstruction (4.1%), and megaureter (2.4%). Complete involution of MCDK occurred within 5 years in 60%. Compensatory hypertrophy of the contralateral kidney to >97% occurred in 74.1%. Nephrectomy was performed in 19.8%. There was an increased risk of chronic kidney disease (CKD) stage 2, and hypertension in those with contralateral abnormalities (p=0.0001; p=0.001 respectively). In those without contralateral abnormalities, hyperfiltration with mean eGFR of 149±13 ml/min/1.73 m2 was seen in 32% and proteinuria in 9.8%. There was a significantly inverse relationship between proteinuria and eGFR (p=0.0001). In conclusion, children with contralateral abnormalities are at risk for developing decreased kidney function, whereas a substantial number of patients with no obvious contralateral abnormalities have markers of renal injury. Therefore, systematic follow-up of all patients is recommended.

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