Retrospective evaluation of children with multicystc dysplastic kidneys

Aim: This study retrospectively evaluated the diagnostic features, associated anomalies, and prognosis of children with multicystic dysplastic kidney (MCDK). Materials and Methods: Medical records of 72 unilateral MCDK cases followed between 2022 and 2024 at the Pediatric Nephrology Clinic of Gaziantep University Faculty of Medicine were reviewed. Demographic features, antenatal ultrasonography, family history/consanguinity, diagnostic ultrasonography (USG) and laboratory results (urea, creatinine), glomerular filtration rate (GFR), proteinuria, voiding cystourethrography (VCUG), dimercaptosuccinic acid (DMSA) scintigraphy, and blood pressure data were recorded. During follow-up, urea/creatinine, GFR, blood pressure, proteinuria, end-stage renal disease (ESRD), and involution were evaluated. Results: Of the patients, 55.6% were female; MCDK was right-sided in 55.6% and left-sided in 44.4% . The mean age at diagnosis was 93 months (0–72). Consanguinity was present in 25% , and a family history of MCDK in 12.5% . At diagnosis, elevated creatinine was detected in 12.1% and elevated urea in 55.6% ; at follow-up, the rates were 10.1% and 69.6% , respectively. Hypertension was observed in 11.1% of 9 patients with records at diagnosis and in 28.3% of 46 patients during follow-up. Urinary tract infection was found in 41.7% . VCUG was performed in 14 patients; 2 had unilateral grade III vesicoureteral reflux (2.8% of all cases). Among 66 patients who underwent DMSA, 10.6% had scarring. Elevated creatinine at diagnosis was associated with DMSA scarring (p=0.004) and hydronephrosis (p=0.007) but not with VUR; no association was found between elevated creatinine at follow-up and scarring (p=0.108). Two patients underwent nephrectomy. Proteinuria was present in 2.7% , while no ESRD was observed. The age of involution did not differ by sex or laterality. Conclusion: The prognosis of unilateral MCDK is generally benign, and surgical intervention is rarely required. Findings support selective imaging based on clinical and ultrasonographic features instead of routine VCUG/DMSA, along with conservative follow-up including regular blood pressure monitoring and urinalysis. Elevated creatinine and marked USG abnormalities at diagnosis warrant closer follow-up.