UNILATERAL MULTICYSTIC DYSPLASTIC KIDNEY - THE CASE FOR NEPHRECTOMY

Management of unilateral multicystic dysplastic kidneys (MCDK) present s physicians and surgeons with a significant dilemma. Recent studies h ave indicated that the incidence of short term complications of MCDK i s low and many authors have recommended conservative nonoperative trea tment. Surgery has been proposed by some because of the potential comp lications of hypertension, infection, and malignant change. Three chil dren with hypertension secondary to MCDK seen at this institution in t he past four years, one of whom had been discharged from follow up as a result of 'disappearance' of the cystic kidney on ultrasound examina tion, are reported. We believe that the risks of hypertension secondar y to MCDK have been understated, and that based on the conclusions of these studies, many children may be receiving suboptimal follow up. We currently favour elective nephrectomy as the treatment of choice for this lesion.