Evidence-based treatment of multicystic dysplastic kidney: a systematic review

Chang, Annette; Sivananthan, D.; Nataraja, Ramesh M.; Johnstone, Lilian; Webb, Nathalie; López, Pedro-José

doi:10.1016/j.jpurol.2018.09.018

Cited by 30 publications

(18 citation statements)

References 73 publications

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“…With the increasing diagnosis of asymptomatic renal anomalies by comprehensive screening programs, MCDK has become one of the most commonly identified congenital anomalies of the urinary tract (13,14). Now that the benign natural history of MCDK is more clearly understood, a non-surgical approach has recently become more popular (2,4,15). However, debate and problems have been continuing in the implementation process in China.…”

Section: Discussionmentioning

confidence: 99%

“…Multicystic dysplastic kidney (MCDK) is a congenital urinary tract anomaly, and is the most common form of cystic kidney disease in children. With the popularization of prenatal ultrasound screening and improvements in ultrasound technology, the diagnosis of asymptomatic renal anomalies is increasing (1,2). In patients with MCDK, the embryonic structure and the development of the renal cortex in the involved kidney(s) are abnormal, and are replaced by multiple non-communicating cysts of varying sizes.…”

Section: Introductionmentioning

confidence: 99%

“…A "watch and wait" strategy is advocated according to recent natural history studies of MCDK (2). However, in some institutions, routine early surgical removal of these kidneys was advocated previously because of concerns about the potential for hypertension and malignancy (11,12).…”

Section: Introductionmentioning

confidence: 99%

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“Watch and Wait” Strategy for Multicystic Dysplastic Kidney (MCDK): Status Survey of Perceptions, Attitudes, and Treatment Selection in Chinese Pediatric Urologists and Pediatric Surgeons

2020

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To investigate the perceptions, attitudes, and treatment selection of Chinese pediatric urologists and pediatric surgeons regarding a "watch and wait" strategy for multicystic dysplastic kidney (MCDK). We used a cross-sectional survey in this study. We sent the questionnaire to pediatric urologists and pediatric surgeons to capture their views via the "Questionnaire Star" online survey platform between November and December 2019. The questionnaire contained the basic information and surgical experiences of the respondent, respondents' awareness regarding the counseling of prenatally-diagnosed MCDK and the treatment of MCDK, and respondents' knowledge regarding the imaging modalities, frequency, and duration of follow-up. Of the 200 questionnaires we sent, we received 151 responses. Of those 151 complete responses, most respondents were women (n = 104, 68.9%), pediatric urologists (n = 78, 51.6%), and practicing with at least 5 years of surgical experience (n = 112, 74.2%); 11.9% reported >20 years' experience. Eighty-two surgeons (54.3%) provided positive counseling for prenatally-diagnosed MCDK. Ninety-nine surgeons (65.6%) advocated conservative management for MCDK, and only 14.8% of respondents suggested limiting the use of radiographic evaluation for MCDK. Surgeons working in academic teaching facilities and those from East China were more likely to select a "watch and wait" strategy. Chinese pediatric urologists and pediatric surgeons have inadequate knowledge of the "watch and wait" strategy for MCDK. An expert consensus on the strategy of "watch and wait" for MCDK in China is urgently needed to promote the application of this non-surgical treatment mode in clinical practice. A larger sample size is required to fully identify the current opinion of Chinese pediatric urologists and pediatric surgeons regarding the management of MCDK.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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“Watch and Wait” Strategy for Multicystic Dysplastic Kidney (MCDK): Status Survey of Perceptions, Attitudes, and Treatment Selection in Chinese Pediatric Urologists and Pediatric Surgeons

2020

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“…At that time detecting these abnormalities demanded nephrectomy as a primary treatment, which was considered as the safest therapy to avoid further complications, such as recurrent urinary tract infections, hypertension, and neoplasia [15,20]. Several studies showed that the prevalence of malignant transformation and hypertension among MCDK patients reflects the occurrence in the general paediatric population [2,17,18,[21][22][23][24]. Moreover, a prospective study published in 2004 by Rabelo et al demonstrated that complete or partial involution is the most frequently observed course of MCDK.…”

Section: Discussionmentioning

confidence: 99%

“…Multicystic dysplastic kidney (MCDK) is one of the most commonly identified urinary tract anomalies, the overall incidence of which is approximately 1 in 4300 live births. It is one of the most frequent causes of a palpable abdominal mass in the neonatal period and is the most common cystic malformation of kidneys in infancy [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Multicystic dysplastic kidney with severe abdominal obstruction signs – case reports and management of children

Czubilińska-Łada¹,

Gliwińska²,

Szymańska³

et al. 2020

polp

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Introduction: Multicystic dysplastic kidney (MCDK) is a relatively common developmental abnormality of the urinary tract. In most cases, it is an asymptomatic disease and rarely leads to problems emerging from the pressing effect of large MCDK kidneys on the adjacent organs. Nowadays, surgical intervention has mostly been replaced by a non-invasive approach with long-term follow-up. Aim of the study: Analysis of the diagnostic process, patients' clinical condition, treatment, and follow-up in neonatal patients with extreme MCDK. Material and methods: Retrospective analysis of medical records of four infants with extreme MCDK, who were hospitalised in the Department of Intensive Therapy and Neonatal Pathology in Independent Public Clinical Hospital No. 1 in Zabrze in 2014-2019. The study also includes data from an outpatient nephrological unit, where infants are checked up by paediatric nephrologists every 6 to 12 months. Results: All four patients involved in this study were diagnosed during the prenatal period. After birth, the initial diagnosis was confirmed by ultrasound, X-ray, computed tomography (CT), magnetic resonance imaging (MRI), and/or scintigraphy. All patients in their neonatal period presented the symptoms caused by the pressing effect of the large size of MCDK kidneys, such as abdominal or flank discomfort, digestive disturbances, or respiratory distress. The life-threatening clinical condition of two of our patients led to surgical intervention, which significantly improved their life functions. The stable clinical condition of another two infants enabled a non-invasive approach. All four infants still remain under long-term follow-up. They are not afflicted with any problems emerging from the urinary tract and they do not require any pharmacological treatment. Conclusions: Despite the currently proposed non-invasive approach to MCDK, there are cases when a nephrectomy should be a considered, especially regarding patients with extreme-sized kidneys.

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Urologic Anomalies and Surgical Implications

Netto

Hittelman

2020

Surgical and Perioperative Management of Patients With Anatomic Anomalies

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Evidence-based treatment of multicystic dysplastic kidney: a systematic review

Cited by 30 publications

References 73 publications

“Watch and Wait” Strategy for Multicystic Dysplastic Kidney (MCDK): Status Survey of Perceptions, Attitudes, and Treatment Selection in Chinese Pediatric Urologists and Pediatric Surgeons

“Watch and Wait” Strategy for Multicystic Dysplastic Kidney (MCDK): Status Survey of Perceptions, Attitudes, and Treatment Selection in Chinese Pediatric Urologists and Pediatric Surgeons

Multicystic dysplastic kidney with severe abdominal obstruction signs – case reports and management of children

Urologic Anomalies and Surgical Implications

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