[Conservative management of multicystic dysplastic kidney: clinical course and ultrasound outcome].
OBJECTIVE
The aim of this study was to describe the clinical course and ultrasound outcome of prenatally detected multicystic dysplastic kidney.


METHODS
Fifty-three children with unilateral multicystic dysplastic kidney detected by prenatal ultrasound between 1989 and 2004 were included in the analysis. All children were submitted to conservative management with follow-up visits every six months. Follow-up ultrasound examinations were performed at six-month intervals during the first two years of life and yearly thereafter. The following clinical parameters were evaluated: blood pressure, urinary tract infection, renal function, and growth. The following ultrasound parameters were evaluated: involution of multicystic dysplastic kidney and contralateral renal growth.


RESULTS
The mean follow-up time was 68 months. Two children presented hypertension during follow-up and five had urinary tract infection (only one with recurrent episodes). There was no malignant degeneration of multicystic dysplastic kidney. A total of 334 ultrasound scans were analyzed. US scan demonstrated involution of the multicystic dysplastic kidney in 48 (90%) cases, including complete involution in nine (17%). The involution rate was faster in the first 30 months of life. There was progressive compensatory renal hypertrophy of the contralateral renal unit; the rate of growth was greater in the first 24 months of life.


CONCLUSIONS
The results of prolonged follow-up of children with conservatively managed multicystic dysplastic kidney suggest that clinical approach is safe, the incidence of complications is small, and that there is a clear tendency for multicystic dysplastic kidney to decrease in size. Our data also suggest that the involution rate of multicystic dysplastic kidney as well as the growth of the contralateral kidney is greater in the first 24 months of life.
Rabêlo
Eli Armando S
EA
Unidade de Nefrologia Pediátrica, Departamento de Cirurgia, Hospital das Clinicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
Oliveira
Eduardo A
EA
Silva
José Maria Penido
JM
Bouzada
Maria Cândida F
MC
Sousa
Bárbara C
BC
Almeida
Mirela N
MN
Tatsuo
Edson Samesima
ES
D017677:Age Distribution; D002675:Child, Preschool; D042241:Early Diagnosis; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D021782:Multicystic Dysplastic Kidney / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D011446:Prospective Studies; D012075:Remission, Spontaneous; D013997:Time Factors; D016216:Ultrasonography, Prenatal