A case of prenatally diagnosed fetal unilateral multicystic dysplastic kidney with contralateral autosomal recessive polycystic kidney / 대한산부인과학회지

Multicystic dysplastic kidney (MCDK) is an incidental finding on prenatal ultrasound examination and this abnormality may be unilateral or bilateral. In approximately 20-50 % of case, there are also abnormalities of the contralateral kidney which should also be evaluated. These abnormalities are mostly bilateral MCDK, vesicoureteral reflux, ureteropelvic junction obstruction or renal agenesis. Unilateral MCDK and contralateral polycystic kidney are very rare congenital anomalies. We experienced 33-year-old multigravida with left MCDK and severe oligohydramnios at 18 weeks gestation. The evaluation of right kidney is difficult due to severe oligohydramnios. After amnioinfusion, the fetus showed enlarged and hyperechoic right kidney. We report a case of unilateral MCDK and contralateral polycystic kidney diagnosed by ultrasonography after amnioinfusion and confirmed by autopsy.

A Case of Prenatally Diagnosed Fetal Unilateral Renal Agenesis with Contralateral Renal Hypoplasia / 대한산부인과학회잡지

Renal agenesis is a disorder characterized by the congenital absence of one or both kidneys due to complete failure of the kidney to form. The syndrome of renal agenesis is severe oligohydramnios, amnion nodosum, flattened face, low-set and floppy ears, and bilateral pulmonary hypoplasia. Bilateral renal agenesis occurs in 0.1 to 0.3 per 1000 births and unilateral involvement occurs in 1 in 500 to 1 in 1300 live births.1,2 Bilateral renal agenesis is an invariably lethal condition, and is associated in more than half of the affected individuals with malformations of the genitourinary tract, cardiovascular system, vertebral bodies or imperforated anus.2 Accurate diagnosis in the mid-trimester permits the parents to allow elective termination. However, the nearly absent amniotic fluid makes an accurate assessment of fetal kidney difficult. We present a case of unilateral renal agenesis with contralateral renal hypoplasia, diagnosed by ultrasonography after amnioinfusion at 21 weeks gestation.