Long-term risk of chronic kidney disease in unilateral multicystic dysplastic kidney

The clinical spectrum of renal dysplasia includes the non-functioning multicystic dysplastic kidney (MCDK). We report our experience of the outcome of unilateral MCDK and its contralateral kidney in 101 children with the diagnosis of MCDK from 1985 to 2009. Data collected included urine protein/crea...

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Published inPediatric nephrology (Berlin, West) Vol. 26; no. 4; pp. 597 - 603
Main Authors Mansoor, Omer, Chandar, Jayanthi, Rodriguez, Maria M., Abitbol, Carolyn L., Seeherunvong, Wacharee, Freundlich, Michael, Zilleruelo, Gaston
Format Journal Article
LanguageEnglish
Published Berlin/Heidelberg Springer-Verlag 01.04.2011
Springer
Springer Nature B.V
Subjects
Adolescent
Blood pressure
Child
Child, Preschool
Chronic kidney failure
Creatinine
Cysts
Dysplasia
Female
Functional Laterality
Humans
Hypertension
Infant
Kidney diseases
Kidney Failure, Chronic - epidemiology
Kidney Failure, Chronic - etiology
Male
Medicine
Medicine & Public Health
Multicystic Dysplastic Kidney - complications
Multicystic Dysplastic Kidney - physiopathology
Nephrology
Original Article
Patients
Pediatrics
Proteins
Risk Factors
Ultrasonic imaging
Urinary tract diseases
Urinary tract infections
Urine
Urogenital system
Urology
United States > US
Multicystic dysplastic kidney
Hyperfiltration
Non-obstructive renal dysplasia
Obstructive renal dysplasia
CKD
Contralateral kidney
Online AccessGet full text

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Abstract The clinical spectrum of renal dysplasia includes the non-functioning multicystic dysplastic kidney (MCDK). We report our experience of the outcome of unilateral MCDK and its contralateral kidney in 101 children with the diagnosis of MCDK from 1985 to 2009. Data collected included urine protein/creatinine ratio, estimated GFR (eGFR), blood pressure, surgical intervention, renal length and abnormalities of the contralateral kidney, and the involution rate. There was a predominance of left-sided MCDK. Diagnosis was made prenatally in 86.7%. Contralateral abnormalities included vesicoureteral reflux (16.8%), UPJ obstruction (4.1%), and megaureter (2.4%). Complete involution of MCDK occurred within 5 years in 60%. Compensatory hypertrophy of the contralateral kidney to >97% occurred in 74.1%. Nephrectomy was performed in 19.8%. There was an increased risk of chronic kidney disease (CKD) stage ≥2, and hypertension in those with contralateral abnormalities ( p  < 0.0001; p  < 0.001 respectively). In those without contralateral abnormalities, hyperfiltration with mean eGFR of 149 ± 13 ml/min/1.73 m 2 was seen in 32% and proteinuria in 9.8%. There was a significantly inverse relationship between proteinuria and eGFR ( p  < 0.0001). In conclusion, children with contralateral abnormalities are at risk for developing decreased kidney function, whereas a substantial number of patients with no obvious contralateral abnormalities have markers of renal injury. Therefore, systematic follow-up of all patients is recommended.
AbstractList The clinical spectrum of renal dysplasia includes the non-functioning multicystic dysplastic kidney (MCDK). We report our experience of the outcome of unilateral MCDK and its contralateral kidney in 101 children with the diagnosis of MCDK from 1985 to 2009. Data collected included urine protein/creatinine ratio, estimated GFR (eGFR), blood pressure, surgical intervention, renal length and abnormalities of the contralateral kidney, and the involution rate. There was a predominance of left-sided MCDK. Diagnosis was made prenatally in 86.7%. Contralateral abnormalities included vesicoureteral reflux (16.8%), UPJ obstruction (4.1%), and megaureter (2.4%). Complete involution of MCDK occurred within 5 years in 60%. Compensatory hypertrophy of the contralateral kidney to >97% occurred in 74.1%. Nephrectomy was performed in 19.8%. There was an increased risk of chronic kidney disease (CKD) stage ≥2, and hypertension in those with contralateral abnormalities (p<0.0001; p< 0.001 respectively). In those without contralateral abnormalities, hyperfiltration with mean eGFR of 149 ±13 ml/ min/1.73 [m.sup.2] was seen in 32% and proteinuriain 9.8%. There was a significantly inverse relationship between proteinuria and eGFR (p<0.0001). In conclusion, children with contralateral abnormalities are at risk for developing decreased kidney function, whereas a substantial number of patients with no obvious contralateral abnormalities have markers of renal injury. Therefore, systematic followup of all patients is recommended.
The clinical spectrum of renal dysplasia includes the non-functioning multicystic dysplastic kidney (MCDK). We report our experience of the outcome of unilateral MCDK and its contralateral kidney in 101 children with the diagnosis of MCDK from 1985 to 2009. Data collected included urine protein/creatinine ratio, estimated GFR (eGFR), blood pressure, surgical intervention, renal length and abnormalities of the contralateral kidney, and the involution rate. There was a predominance of left-sided MCDK. Diagnosis was made prenatally in 86.7%. Contralateral abnormalities included vesicoureteral reflux (16.8%), UPJ obstruction (4.1%), and megaureter (2.4%). Complete involution of MCDK occurred within 5 years in 60%. Compensatory hypertrophy of the contralateral kidney to >97% occurred in 74.1%. Nephrectomy was performed in 19.8%. There was an increased risk of chronic kidney disease (CKD) stage ≥2, and hypertension in those with contralateral abnormalities (p<0.0001; p< 0.001 respectively). In those without contralateral abnormalities, hyperfiltration with mean eGFR of 149 ±13 ml/ min/1.73 [m.sup.2] was seen in 32% and proteinuriain 9.8%. There was a significantly inverse relationship between proteinuria and eGFR (p<0.0001). In conclusion, children with contralateral abnormalities are at risk for developing decreased kidney function, whereas a substantial number of patients with no obvious contralateral abnormalities have markers of renal injury. Therefore, systematic followup of all patients is recommended. Keywords Multicystic dysplastic kidney * Contralateral Kidney * CKD * Hyperfiltration * Non-obstructive renal Dysplasia * Obstructive renal dysplasia
The clinical spectrum of renal dysplasia includes the non-functioning multicystic dysplastic kidney (MCDK). We report our experience of the outcome of unilateral MCDK and its contralateral kidney in 101 children with the diagnosis of MCDK from 1985 to 2009. Data collected included urine protein/creatinine ratio, estimated GFR (eGFR), blood pressure, surgical intervention, renal length and abnormalities of the contralateral kidney, and the involution rate. There was a predominance of left-sided MCDK. Diagnosis was made prenatally in 86.7%. Contralateral abnormalities included vesicoureteral reflux (16.8%), UPJ obstruction (4.1%), and megaureter (2.4%). Complete involution of MCDK occurred within 5 years in 60%. Compensatory hypertrophy of the contralateral kidney to >97% occurred in 74.1%. Nephrectomy was performed in 19.8%. There was an increased risk of chronic kidney disease (CKD) stage ≥2, and hypertension in those with contralateral abnormalities ( p  < 0.0001; p  < 0.001 respectively). In those without contralateral abnormalities, hyperfiltration with mean eGFR of 149 ± 13 ml/min/1.73 m 2 was seen in 32% and proteinuria in 9.8%. There was a significantly inverse relationship between proteinuria and eGFR ( p  < 0.0001). In conclusion, children with contralateral abnormalities are at risk for developing decreased kidney function, whereas a substantial number of patients with no obvious contralateral abnormalities have markers of renal injury. Therefore, systematic follow-up of all patients is recommended.
The clinical spectrum of renal dysplasia includes the non-functioning multicystic dysplastic kidney (MCDK). We report our experience of the outcome of unilateral MCDK and its contralateral kidney in 101 children with the diagnosis of MCDK from 1985 to 2009. Data collected included urine protein/creatinine ratio, estimated GFR (eGFR), blood pressure, surgical intervention, renal length and abnormalities of the contralateral kidney, and the involution rate. There was a predominance of left-sided MCDK. Diagnosis was made prenatally in 86.7%. Contralateral abnormalities included vesicoureteral reflux (16.8%), UPJ obstruction (4.1%), and megaureter (2.4%). Complete involution of MCDK occurred within 5 years in 60%. Compensatory hypertrophy of the contralateral kidney to >97% occurred in 74.1%. Nephrectomy was performed in 19.8%. There was an increased risk of chronic kidney disease (CKD) stage ≥ 2, and hypertension in those with contralateral abnormalities (p<0.0001; p<0.001 respectively). In those without contralateral abnormalities, hyperfiltration with mean eGFR of 149 ± 13 ml/min/1.73 m(2) was seen in 32% and proteinuria in 9.8%. There was a significantly inverse relationship between proteinuria and eGFR (p<0.0001). In conclusion, children with contralateral abnormalities are at risk for developing decreased kidney function, whereas a substantial number of patients with no obvious contralateral abnormalities have markers of renal injury. Therefore, systematic follow-up of all patients is recommended.
The clinical spectrum of renal dysplasia includes the non-functioning multicystic dysplastic kidney (MCDK). We report our experience of the outcome of unilateral MCDK and its contralateral kidney in 101 children with the diagnosis of MCDK from 1985 to 2009. Data collected included urine protein/creatinine ratio, estimated GFR (eGFR), blood pressure, surgical intervention, renal length and abnormalities of the contralateral kidney, and the involution rate. There was a predominance of left-sided MCDK. Diagnosis was made prenatally in 86.7%. Contralateral abnormalities included vesicoureteral reflux (16.8%), UPJ obstruction (4.1%), and megaureter (2.4%). Complete involution of MCDK occurred within 5 years in 60%. Compensatory hypertrophy of the contralateral kidney to >97% occurred in 74.1%. Nephrectomy was performed in 19.8%. There was an increased risk of chronic kidney disease (CKD) stage ≥2, and hypertension in those with contralateral abnormalities (p<0.0001; p<0.001 respectively). In those without contralateral abnormalities, hyperfiltration with mean eGFR of 149±13 ml/min/1.73 m^sup 2^ was seen in 32% and proteinuria in 9.8%. There was a significantly inverse relationship between proteinuria and eGFR (p<0.0001). In conclusion, children with contralateral abnormalities are at risk for developing decreased kidney function, whereas a substantial number of patients with no obvious contralateral abnormalities have markers of renal injury. Therefore, systematic follow-up of all patients is recommended.[PUBLICATION ABSTRACT]
Audience Academic
Author Zilleruelo, Gaston
Rodriguez, Maria M.
Seeherunvong, Wacharee
Mansoor, Omer
Freundlich, Michael
Abitbol, Carolyn L.
Chandar, Jayanthi
Author_xml – sequence: 1
  givenname: Omer
  surname: Mansoor
  fullname: Mansoor, Omer
  organization: Division of Pediatric Nephrology, Holtz Children’s Hospital, Department of Pediatrics, University of Miami Miller School of Medicine
– sequence: 2
  givenname: Jayanthi
  surname: Chandar
  fullname: Chandar, Jayanthi
  email: jchanda2@med.miami.edu
  organization: Division of Pediatric Nephrology, Holtz Children’s Hospital, Department of Pediatrics, University of Miami Miller School of Medicine
– sequence: 3
  givenname: Maria M.
  surname: Rodriguez
  fullname: Rodriguez, Maria M.
  organization: Division of Pediatric Pathology, Holtz Children’s Hospital, Department of Pathology, University of Miami Miller School of Medicine
– sequence: 4
  givenname: Carolyn L.
  surname: Abitbol
  fullname: Abitbol, Carolyn L.
  organization: Division of Pediatric Nephrology, Holtz Children’s Hospital, Department of Pediatrics, University of Miami Miller School of Medicine
– sequence: 5
  givenname: Wacharee
  surname: Seeherunvong
  fullname: Seeherunvong, Wacharee
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– sequence: 6
  givenname: Michael
  surname: Freundlich
  fullname: Freundlich, Michael
  organization: Division of Pediatric Nephrology, Holtz Children’s Hospital, Department of Pediatrics, University of Miami Miller School of Medicine
– sequence: 7
  givenname: Gaston
  surname: Zilleruelo
  fullname: Zilleruelo, Gaston
  organization: Division of Pediatric Nephrology, Holtz Children’s Hospital, Department of Pediatrics, University of Miami Miller School of Medicine
BackLink https://www.ncbi.nlm.nih.gov/pubmed/21240528$$D View this record in MEDLINE/PubMed
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ISSN 0931-041X
IngestDate Sat Aug 17 02:35:50 EDT 2024
Thu Oct 10 22:10:36 EDT 2024
Thu Feb 22 23:32:02 EST 2024
Fri Feb 02 05:11:35 EST 2024
Fri Feb 02 04:04:38 EST 2024
Tue Aug 20 22:10:38 EDT 2024
Thu Sep 12 18:10:58 EDT 2024
Tue Oct 15 23:40:38 EDT 2024
Sat Dec 16 11:59:58 EST 2023
IsPeerReviewed true
IsScholarly true
Issue 4
Keywords Multicystic dysplastic kidney
Hyperfiltration
Non-obstructive renal dysplasia
Obstructive renal dysplasia
CKD
Contralateral kidney
Language English
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PublicationSubtitle Journal of the International Pediatric Nephrology Association
PublicationTitle Pediatric nephrology (Berlin, West)
PublicationTitleAbbrev Pediatr Nephrol
PublicationTitleAlternate Pediatr Nephrol
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Snippet The clinical spectrum of renal dysplasia includes the non-functioning multicystic dysplastic kidney (MCDK). We report our experience of the outcome of...
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SubjectTerms Adolescent
Blood pressure
Child
Child, Preschool
Chronic kidney failure
Creatinine
Cysts
Dysplasia
Female
Functional Laterality
Humans
Hypertension
Infant
Kidney diseases
Kidney Failure, Chronic - epidemiology
Kidney Failure, Chronic - etiology
Male
Medicine
Medicine & Public Health
Multicystic Dysplastic Kidney - complications
Multicystic Dysplastic Kidney - physiopathology
Nephrology
Original Article
Patients
Pediatrics
Proteins
Risk Factors
Ultrasonic imaging
Urinary tract diseases
Urinary tract infections
Urine
Urogenital system
Urology
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Title Long-term risk of chronic kidney disease in unilateral multicystic dysplastic kidney
URI https://link.springer.com/article/10.1007/s00467-010-1746-0
https://www.ncbi.nlm.nih.gov/pubmed/21240528
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Volume 26
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