CLINICAL-FEATURES OF UNILATERAL MULTICYSTIC RENAL DYSPLASIA IN CHILDREN

yA clinical study of 204 patients with unilateral multicystic renal dy splasia referred to 30 nephrology departments was undertaken to assess the frequency of complications in children who underwent nephrectomy (n = 40) versus those who were treated conservatively (n = 164). Six p atients required antihypertensive treatment, 30 (13% of girls, 17% of boys) had at least one episode of urinary tract infection. The number of clinical complications did not differ in patients who underwent nep hrectomy in comparison to those who did not. The dysplastic kidney dec reased in size in 65% of kidneys with repeated ultrasound values; no c hange occurred in 16%, while an increase in maximal diameter was obser ved in 19%. Contralateral kidney length of more than 2 standard deviat ion scores (SDS) was seen in 30% of patients. There is evidence for a slight impairment of renal function in the whole study group given by a median of serum creatinine level of 0.63 SDS in all patients availab le for analysis. Among those 35 patients with contralateral anomalies (mainly obstructive changes and vesico-ureteral reflux), all 3 patient s with contralateral changes suggestive of hypoplasia and 22% with obs truction, but only 1/7 (14%) with reflux showed elevated serum creatin ine level >2 SDS. Conclusion Renal function seems to be slightly impai red in patients with unilateral multicystic renal dysplasia. The appar ent tendency to regression of the dysplastic kidney and no difference in the number of complications justify a conservative management rathe r than operative intervention.