Case profile: Adult multicystic kidney

Abstract

A twenty-six-year-old Mexican woman was seen because of recurrent lower urinary tract infections. Episodes of cystitis responded to appropriate antibiotics. The patient complained of mild intermittent bilateral flank discomfort, although no bouts of pyelonephritis were ever documented. Findings on physical examination were unremarkable. An intravenous pyelogram was obtained (Fig. lA, B). Curvilinear calcifications without functioning renal parenchyma were noted on the left. A normally functioning hypertrophied kidney was present on the right. A left retrograde ureterogram demonstrated a small caliber, hypoplastic, blind-ending ureter (Fig. 1C). Multicystic kidney in adults should be recognized by the triad of ring calcifications, absence of functioning renal tissue, and atretic ureter. ’ The visualized portion of ureter may contain pseudosacculations. Grossly, multiple grapelike cysts are present that do not communicate and are held together by connective tissue. Treatment is somewhat controversial since many of these adult multicystic kidneys are found incidentally and are treated expectantly, although flank and upper quadrant pain, re