Multicystic dysplastic kidney: Ten-year evaluation

Abstract

Introduction: Multicystic dysplastic kidney (MCDK) is the most common form of developmental abnormality seen in infants and children. It is almost always unilateral and slightly more frequent in boys and on the left side. The other associated extra-renal abnormalities include esophageal atresia, tracheoesophageal atresia, ventricular septal defect and patent ductus arteriosus. The routine widespread use of antenatal ultrasonography has led to early detection of this abnormality. Materials and Methods: We retrospectively assessed fourteen cases of Multicystic dysplastic kidney between January 2004 and December 2014. All the cases underwent total nephrectomy and the specimens were sent to the department of Pathology with their respective clinical details and pathological findings were analyzed. Results: A total of fourteen (14) patients were diagnosed with unilateral MCDK over a period of 10 years with no sex predilection. Majority were on left side and antenatally diagnosed. Some patients had associated hypertension, vesicoureteral reflux and ureteropelvic junction obstruction. Microscopy revealed renal parenchyma replaced by cysts of variable sizes lined by flattened cuboidal epithelium. Intervening fibrotic stroma with mesenchymal components, primitive glomeruli, nerve bundles and dysplastic ducts. Conclusion: MCDK is mostly a unilateral sporadic anomaly usually found on the left side, however can be familial. It may be associated with hypertension, vesicoureteral reflux and ureteropelvic junction obstruction. Most of the patients can be diagnosed antenatally and confirmed on histopathology. Keywords: Multicystic dysplastic kidney, Dysplastic kidney, Cystic kidney.