Insurability of Children With Congenital Urological Anomalies

Abstract

Despite limited long-term data on and uncertainty about the natural course of multicystic dysplastic kidney and unilateral neonatal hydronephrosis, treatment options offered a child with a congenital urological anomaly may have a significant impact on the ability to obtain life insurance. Children with multicystic dysplastic kidney and unilateral neonatal hydronephrosis can usually obtain life insurance after early operative intervention (nephrectomy and pyeloplasty, respectively), although sometimes at higher cost.

Concomitant anomalies in 100 children with unilateral multicystic kidney

“…Removal of the unilateral multicystic kidney as a standard procedure is still under debate. In some studies the kidney was removed because of fear of potential complications such as hypertension18, infection15 or malignancy17, 19; in others the children were examined periodically because the risk of developing malignancy or hypertension was considered to be very low or even nonexistent2, 15.…”

Unilateral multicystic dysplastic kidney: long term outcomes

“…[2][3][4] A conservative approach to children with MCDK has therefore been advocated, but others have suggested surgical removal on the basis of risk of hypertension, mass effect, potential for malignant change, and cost of repeated ultrasound examination. [5][6][7] Patients with a unilateral MCDK need to be evaluated for abnormalities in the contralateral kidney, with the reported incidence of vesicoureteric reflux (VUR) being 11-37%. 2 8-10 Vesicoureteric junction obstruction (VUJ) and, more commonly, pelviureteric junction obstruction (PUJ), has also been reported in the contralateral kidney.…”

Child development services in Medicaid managed care organizations

“…13,14 There is no reason from our data collection efforts to believe a systematic bias in non-response exists, and comparisons between the sample and the population revealed no differences in plan characteristics. 13,14 There is no reason from our data collection efforts to believe a systematic bias in non-response exists, and comparisons between the sample and the population revealed no differences in plan characteristics.…”

“…With considerable follow-up, we achieved a response rate of 40%; this response rate compares favourably with other surveys of MMCOs. 13,14 There is no reason from our data collection efforts to believe a systematic bias in non-response exists, and comparisons between the sample and the population revealed no differences in plan characteristics. Nevertheless, we cannot rule out the possibility that the sample who responded to the survey is not representative of all MMCOs and may under-or over-represent the degree to which developmental assessments and child development services are promoted or required by MMCOs.…”