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Journal of the Korean Society of Pediatric Nephrology 2000;4(1): 63-68.
편측성 다낭포성 신이형성증 (Unilateral multicystic dysplastic kidney)의 임상 경과
유지형, 육진원, 김지홍, 김병길, 한상원, 김명준
1연세대학교 의과대학 소아과학교실, 신장질환연구소
2연세대학교 의과대학 소아과학교실, 신장질환연구소
3연세대학교 의과대학 소아과학교실, 신장질환연구소
4연세대학교 의과대학 소아과학교실, 신장질환연구소
5연세대학교 의과대학 비뇨기과학교실
6연세대학교 의과대학 진단방사선과학교실
Analysis of Children with Unilateral Multicystic Dysplastic Kidney(MCDK)
Ji Hyung Yoo, Jinwon Yook, Ji Hong Kim, Pyung-Kil Kim, Sang Won Han, Myung Joon Kim
1Department of Pediatrics and Institute of Kidney Disease, Yonsei University, College of Medicine
2Department of Pediatrics and Institute of Kidney Disease, Yonsei University, College of Medicine
3Department of Pediatrics and Institute of Kidney Disease, Yonsei University, College of Medicine
4Department of Pediatrics and Institute of Kidney Disease, Yonsei University, College of Medicine
5Department of Urology, Yonsei University, College of Medicine
6Department of Radiology, Yonsei University, College of Medicine
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ABSTRACT
Purpose: MCDK is regarded as a common cause of abdominal masses in children. And the presentation of the MCDK is usually a unilateral flank mass in the a newborn. Bialteral disease results in either fetal demise or necessity fer renal replacement therapy at birth. This study is designed to assess the clinical features and natural history of the unilateral multicystic dysplastic kidney.
Patients and Methods : From January 1987 to January 2000 data were obtained retrospectively on 57 patients (28 boys and 29 girls, age ranged 1day-11years) who had a diagnosis of multicystic dysplastic kidney. The diagnosis of multicystic dysplastic kidney was confirmed by a combination of ultrasonography and radionuclide scan. Voiding cystourethrogram study in 31 patients were done to determine the condition of the contalateral kidney. Restllts: $84%$ of the patients were diagnosed before birth by antenatal ultrasonography Clinical manifestations of children with postnatal diagnoses were palpable abdominal mass($3.5%$), abdominal distension($17%$), and incidental($10.5%$). The abnormalities in contralateral kidney were hydronephrosis($21%$), compensatory hypertrophy($12%$), simple cyst($2%$), bifid pelvis($2%$). Surgical management was performed in 20 patients($35%$) due to recurrent infection, for diagnostic purpose to differentiate from malignancy and abdominal distention. Follow-up in the remaining 37 patients continued (mean 18 months) and results of sonogram findings were involution change in 23 patients($40%$) and no interval changes in 13 patient($23%$).
Conclusions : The apparent tendency to regression of the dysplastic kidney and no difference in the number of complications justify a conservative management rather than operative intervention except in associated severe complications such as urinary tract infection or rupture of cysts.
Key words: Multicystic dysplastic kidney
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