ABSTRACT
Objective: To report the renal structural and functional anomalies in children with multicystic dysplastic kidneys. Methods: Retrospective descriptive analysis of 47 children with multicystic dysplastic kidney seen in a pediatric nephrology unit over a period of 6 years. Results: Antenatal diagnosis of multicystic dysplastic kidney was made in 34 (72.3%) patients. On follow up of 31 children for more than 12 months, 21 (68%) had involution, 4 [13%] had non-regression, and 4 (13%) were nephrectomized. Vesico-ureteric reflux (n=13; 28%) was the commonest renal abnormality. The serum creatinine values were higher (P=0.006) in children with contralateral reflux. Sub-nephrotic proteinuria was noted in 9 (29%) and was significantly associated with complete involution (P=<0.023). None of the patients developed hypertension and 2 (6.4%) had renal failure. Conclusion: Close nephrological follow-up is needed in children with multicystic dysplasia of kidneys.
ABSTRACT
The hyperfiltration hypothesis postulates that kidney with reduced renal mass will progress toward failure due to hypertrophy of the remaining nephron to meet the excess load, eventually leading to nephron exhaustion. We assessed the influence of renal size on graft function in all allogrft except loss of graft within 6 month between September 1995 and February 1997(n=58). Patients were divided into two groups based on the ratio of kidney weight to recipient body surface area(KW/BSA>or=0.11, KW/BSAor=0.3, KW/BW<0.3) respectively and outcomes were compared by methods including student t-test and Chi-square test. Three conditions, in which hyperfiltration might be suspected, proposed by Teraski, were studied also: grafts from females to males compared with males to females, kidneys that experience rejection episodes and cadaveric grafts compared with living donor grafts. There was no correlation between KW/BSA, KW/BW and serum creatinine and degree of proteinuria at 1, 3, 6, 12 months posttransplant. Three conditions under which hyperfiltration damage might be suspected had no differences in study groups. Although more cases should be studied with long term follow-up, we conclude that donor kidney size has no apparent effect on renal allograft outcome in short term follow-up.