Multicystic Kidney: Clinical Features and Management / 대한비뇨기과학회지

ABSTRACT

Multicystic kidney is one of the most frequent causes of neonatal abdominal mass. Controversy continues as to the optimal management of these lesions since little is known about their natural history. Most multicystic kidneys are presented as asymptomatic abdominal mass or detected incidentally on prenatal ultrasonography. Recently in Korea, diagnosis of multicystic kidney is increasing as prenatal ultrasonography becomes more popular. Herein we observed clinical features of the 24 cases of multicystic kidney including the 16 cases of prenatal diagnosis. Male patients were predominant( 159) and the right kidney was found slightly more often than the left kidney ( 14 10). Contralateral kidney abnormality were found in 3 cases( 29% ). In 24 cases, 21 were managed nonoperatively, and nephrectomy was performed in 3 cases a case of huge abdominal mass, a case of infection after antegrade pyelography and a case misdiagnosed as UPJ obstruction preoperatively. In 19 cases during the average 27.1 months ultrasound followup, the size of multicystic kidney has been unchanged or decreased. There were no medical complication and no evidence of malignant development. Our data shows that the patients of multicystic kidney can be managed conservatively on the basis of features of followup ultrasonography and clinical symptoms. But complete urologic evaluation is necessary to identify abnormalities in the contralateral kidney. We believe that surgery is option in those patients in whom the cystic mass appears to be growing, hypertension develops, or Malignancy is in question.