Multicystic Renal Dysplasia Clinical Presentation

Updated: Jun 22, 2020
  • Author: Agnieszka Swiatecka-Urban, MD, FASN, FAAP; Chief Editor: Craig B Langman, MD  more...
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Presentation

History

Most cases of multicystic dysplasia of the kidney (MCDK) are detected during fetal ultrasonography and are reported as early as 15 weeks' gestation. Prior to fetal ultrasonography, an abdominal mass in the flank of an otherwise healthy newborn was the most common clinical presentation of unilateral multicystic dysplastic kidney.

In prenatally diagnosed multicystic dysplastic kidney, the abnormal kidney is palpable in only 13-22% of patients. The mass is usually mobile, ballotable, irregular in shape, nontender, and might transilluminate.

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Physical Examination

Multicystic dysplastic kidney is usually asymptomatic and can remain undetected into adulthood. Abdominal or flank pain and respiratory distress are uncommon symptoms because of the pressure effect of the abnormal kidney.

Multicystic dysplastic kidney might be discovered during an investigation for urinary tract infection (UTI), voiding dysfunction, or hypertension. Multicystic dysplastic kidney may also be discovered when diagnostic imaging studies are performed to investigate a nonurinary problem.

Bilateral multicystic dysplastic kidney usually results in stillbirth or death within the first few days of life; however, an infant with bilateral multicystic dysplastic kidney who survived for 17 days was reported. Bilateral multicystic dysplastic kidney is usually associated with oligohydramnios, amnion nodosum, pulmonary hypoplasia, and Potter facies. Infants with bilateral multicystic dysplastic kidney who survive have renal failure from birth and require dialysis from the first day of life.

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