Conservative Management of Segmental Multicystic Dysplastic Kidney in Children.
OBJECTIVE
To assess the clinical characteristics and natural course of segmental multicystic dysplastic kidney (MCDK).


METHODS
We retrospectively analyzed the medical records of 40 patients (43 renal units) diagnosed as having segmental MCDK between January 2002 and June 2014. Segmental MCDK was classified as typical when it was localized to the upper pole of a duplex collecting system, and otherwise as atypical. We investigated involution, associated anomalies requiring surgery, and complications of segmental MCDK.


RESULTS
Of 43 renal units, 23 were typical and 20 were atypical. During 71.5 (interquartile range: 37.5-84.1) months of median follow-up period, complete and partial involution were observed in 48% and 26% of the typical group and 30% and 35% of the atypical group, respectively. In the typical group, involution was complete significantly earlier (P = .048) and ipsilateral anomalies were more frequently observed (P = .002). The initiation point of involution and contralateral anomalies were not different in the two groups. Hypertension developed in 1 case with contralateral MCDK and 1 case with contralateral renal agenesis.


CONCLUSIONS
Segmental MCDK is not a rare disease entity, and conservative treatment appears to be sufficient with thorough follow-up, including regular monitoring of blood pressure and renal function, and with ultrasonography.
Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
Jang Hee
JH
Han
Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
Yong Seung
YS
Lee
Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
Myung-Joon
MJ
Kim
Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
Mi-Jung
MJ
Lee
Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
Young Jae
YJ
Im
Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
Sang Woon
SW
Kim
Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea. Electronic address: swhan@yuhs.ac.
Sang Won
SW
Han
D000367:Age Factors; D001707:Biopsy, Needle; D001795:Blood Pressure Determination / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007677:Kidney Function Tests; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D021782:Multicystic Dysplastic Kidney / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D057832:Watchful Waiting / Q000379:methods