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2012, Number 2

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Rev Cubana Pediatr 2012; 84 (2)

Multicystic renal dysplasia: is it appropriate to follow the conservative treatment or nephrectomy?

Durán ÁS, Calviac MR, Díaz ZN

Language: Spanish
References: 34
Page:
PDF size: 51.53 Kb.


ABSTRACT

Introduction: multicystic renal dysplasia is a relatively frequent anomaly that still arouses some discrepancies about the medical behaviour to be followed.
Objectives: to analyze the evolution of cysts in a group of patients prenatally diagnosed with this anomaly, with whom a conservative and expectant medical behaviour was adopted.
Methods: from January 1st, 1996 to June 30th, 2011, the nephrology service of "William Soler" university pediatric hospital assisted 22 newborns and infants, who were diagnosed with multicystic renal dysplasia or other anomaly during the normal pregnancy follow-up, but later dysplasia was confirmed after birth. All these patients underwent renal ultrasound on arrival at hospital, and then static gammagraphy (99m technetium-DMSA) to see the renal function of the affected side and to assess the characteristics of the contralateral kidney. A conservative and expectant behaviour was observed for all the cases; the objective of this study was attained in 21 of these children.
Results: males prevailed in 60 % of patients, left kidney was affected in 77 % of cases and the "typical" form of dysplasia was present in 80 % of them. Six infants presented with other related anomalies. There was prenatal regression of cysts in three children, total regression ranging 3 to 72 months in 9 infants (50 % of the infants under study after birth) whereas partial regression occurred in 6 cases (33.3 %) and 3 did not change their condition (16.7 %).
Conclusions: the conservative treatment should be the initial choice for every patient with multicystic renal dysplasia since total regression is possible in most of cases in a relatively short period of time.


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