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Arch Dis Child 1997;76:31-34 ( January )

Unilateral multicystic dysplastic kidney: the case for nephrectomy

N J A Webb,a M A Lewis,a J Bruce,b D C S Gough,b E J Ladusans,c A P J Thomson,d R J Postlethwaitea

a Manchester Children's Hospital, Pendlebury, Manchester M27 4HA: Department of Nephrology, b Department of Urology, c Department of Cardiology, d Department of Paediatrics, Leighton Hospital, Crewe

Correspondence to: Dr Lewis.

Accepted 28 August 1996

Management of unilateral multicystic dysplastic kidneys (MCDK) presents physicians and surgeons with a significant dilemma. Recent studies have indicated that the incidence of short term complications of MCDK is low and many authors have recommended conservative non-operative treatment. Surgery has been proposed by some because of the potential complications of hypertension, infection, and malignant change. Three children with hypertension secondary to MCDK seen at this institution in the past four years, one of whom had been discharged from follow up as a result of `disappearance' of the cystic kidney on ultrasound examination, are reported. We believe that the risks of hypertension secondary to MCDK have been understated, and that based on the conclusions of these studies, many children may be receiving suboptimal follow up. We currently favour elective nephrectomy as the treatment of choice for this lesion.

Keywords: multicystic dysplastic kidney; complications; hypertension; nephrectomy.

© 1997 by Archives of Disease in Childhood


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