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Urinary and Genital Disorders (Children)

Multicystic dysplastic kidney

10/24/2008

Question:

My son is 2yrs old and has been diagnosed with MCDK a month ago. I had two level 2 ultrasounds when I was pregnant, one at 18 wks and the other at 20 wks gestation. These were to determine if there was a pericardial effusion. The kidneys were reported as being unremarkable. Is it possible that MCDK could not have been seen then? I am worried that the doctors are missing something. This mass was discovered by accident during a abdominal CT he had in the ER for abdominal pain. Since then he has had a contrast MRI, and 2 ultrasounds. He has another ultrasound and a contrast VCUG set up in 3 wks. I have read that MCDK is diagnosed before birth and since I work in a radiology department I would always let the ultrasound techs do practice fetal ultrasounds on me, right up to when he was born. So even if the level 2 ultrasounds didn`t show anything wouldn`t the mass show on those scans?

Answer:

Most of the time an early fetal ultrasound would show the multicystic kidney. It is possible that the diagnosis is not a multicystic kidney, but rather an obstructed kidney from a UPJ obstruction. However, personal review of the studies would be necessary. Your child has a complex finding and consultation with a pediatric urologist would be beneficial.

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Response by:

Jack S Elder, MD, FACS, FAAP Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University