The natural history of the multicystic dysplastic kidney – Is limited follow-up warranted?

Conservative Management of Segmental Multicystic Dysplastic Kidney in Children

“…However, the approach to treating MCDK is now changing to one of conservative management with close follow-up monitoring, due to the rare complication rate of the disease. 4 Hypertension was reported in one case in an one-year-old Indian girl having segmental MCDK in a previous report. 26 …”

“…4 In 3 This group is more likely related to the MCDK group, which is characterized by male predominance and is left side dominant. 18 However, the exact etiology for each group has not been established.…”

“…3 Malignancy in MCDK is exceedingly rare, and the prevalence of hypertension mirrors that of the general pediatric population. 4 For these reasons, conservative treatment is generally recommended.…”

Multicystic dysplastic kidney (MCDK) in the neonate: The role of the urologist

“…3 On the other end of the spectrum is the recommendation for ongoing follow up with US imaging, starting with a renal US every six months for the first two years and yearly thereafter, until the MCDK completely involutes. 4 Nephrectomy continues to be considered by some as a suitable treatment option for MCDKs that do not involute or are unlikely to involute.…”

“…6 These authors advocate for ongoing followup allowing for early identification of those at risk and timely intervention. [6][7][8][9] Regarding the use of voiding cystourethrograms (VCUGs), the literature suggests some urologists continued to routinely perform them in all children with MCDK until as recently as 2012, 10 with more recent publications advocating for judicious use of VCUG, only being ordered when US shows contralateral anomalies, 3 or only ordering a VCUG if the child has a urinary tract infection, regardless of the presence of mild contralateral hydronephrosis. 11 Though not included in the initial guideline, it has been shown that 15% of children with MCDK have malformations of the ipsilateral internal genitalia, warranting followup.…”