ESPN 51th Annual Meeting

ESPN 2018


 
INVOLUTION OF MULTICYSTIC DYSPLASTIC KIDNEY AND GROWTH OF CONTRALATERAL KIDNEY
AKGUN YILMAZ ALKAC 1 CEMALIYE BASARAN 1 NIDA TEMIZKAN DINCEL 1 EBRU YILMAZ 1 ORHAN DENIZ KARA 1 SUKRAN KESKIN GOZMEN 1 FATMA DEVRIM 1 SERKAN KEMER 1 MUSTAFA BAK 1 ERKIN SERDAROGLU 1

1- UNIVERSITY OF HEALTH SCIENCES DR. BEHCET UZ CHILDRENS HOSPITAL DEPARTMENT OF PEDIATRIC NEPHROLOGY
 
Introduction:

 Multicystic dysplastic kidney (MCDK) is one of the most frequent congenital renal anomalies in antenatal development. The aim of the study was to determine involution of MCDK and growth of contralateral kidney, also to define additional urinary anomalies.

Material and methods:

 The study was enrolled by 75 patients with MCDK. Blood pressure, serum creatinine and kidney sizes at presentation and on the last follow up were recorded. Estimated glomerular filtration rate (eGFR) was calculated using by Schwartz formula. Delta eGFR was defined as alteration of eGFR between the time of diagnosis and the last control. The patients were divided into 2 groups according to whether additional anomalies (group 1) or not (group 2).

Results:

 There were 20 cases (26.7%) in group 1 and 55 (73.3%) in group 2. Additional anomalies were vesicoureteral reflux in 7 (9.3%) and hydronephrosis in 13 (17.3%) in group 1.The mean follow-up of patients was 33±36 months. Forty-seven cases (62.7 %) were diagnosed prenatally. Involution rates (73.7% and 76.9%) and times (39.8 and 61.7 mo) were similar between 2 groups. There was compensatory hypertrophy (51 patients) in contralateral kidney. Delta eGFR values was found higher in group 1 (31±46 and 10±20 ml/dk /1.73 m² ) than 2 (p=0.008). None of our patients had hypertension or proteinuria or chronic kidney disease. One patient had hypertension on the initial diagnosis, underwent nephrectomy and hypertension resolved.

Conclusions:

 The prognosis of unilateral MCDK depends on the contralateral kidney. Life-long close monitoring of renal function, blood pressure and urine analysis is required in these patients. We suggest that; significant higher delta eGFR in patients with additional anomalies should be pointed hyperfiltration of contralateral kidney in additional anomalie group and may be important in long-term follow-up.