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Multicystic dysplastic kidney - unilateral

Case contributed by Manish Malik
Diagnosis almost certain

Presentation

Primigravida patient with 25 weeks period of gestation.

Patient Data

Age: 30 years
Gender: Female

Antenatal screening

ultrasound

Detailed fetal anatomical survey at 25 weeks of gestation in a primigravida female show enlarged echogenic left kidney with normal renal parenchyma replaced by multiple small varying sized non-communicating cysts.

The contralateral right kidney is normal in size and echopattern.

The urinary bladder is well visualized.

Case Discussion

Multicystic dysplastic kidney disease (MCDK) is most commonly an incidental finding. The contralateral kidney is mostly normal but it may occur bilaterally or with contralateral agenesis and can be fatal. The affected kidney appears enlarged with multiple usually peripherally placed non-communicating cysts of variable size. Normal intervening renal parenchyma is usually lost in the affected kidney. 

Unilateral multicystic dysplastic kidney disease with absent associated anomalies, normal karyotype and adequate amniotic fluid volume are good prognostic indicators.

A complete neonatal work-up and follow-up with ultrasound KUB every 3-4 months are mandatory during the first year of life. The cysts initially increase in size and number followed by involutional changes either in utero or postnatal.

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