Abstract
Objective Surgery is still indicated as the treatment of choice in subset of patients with
unilateral multicystic dysplastic kidney (UMCDK) because of its potential complications
and malignant change. The purpose of this study is to present our observation that
early nephrectomy may cure hypertension early in children with UMCDK and review the
literature.
Materials and Methods We report here four children (two males and two females) with antenatally diagnosed
UMCDK with hypertension, treated in the past 4 years. All have antenatal diagnosis
of UMCDK and referred to us after their birth. Diagnosis of hypertension (blood pressure
> 95th percentile) was made after 3 months of follow-up in all patients. Nephrectomy
was performed in all children in variable time duration. Hypertension, urinary tract
infection, and desire of parents were the main indication of surgery.
Results All children showed decrease in the size of their dysplastic kidney with time, but
hypertension was persistent and needed antihypertensive drugs; even increase in the
doses in successive follow-up. After nephrectomy, three children who were operated
early got cured having normal blood pressure within variable time duration, while
a child, operated late, still had high blood pressure and needed antihypertensive
drugs.
Conclusion Early nephrectomy in recently diagnosed hypertension in UMCDK is advisable and can
cure hypertension early.
Levels of Evidence The level of evidence is IV (case series with no comparison group).
Keywords
unilateral multicystic dysplastic kidney - nephrectomy - hypertension
