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Urinary and Genital Disorders (Children)

Abnormal kidneys on ultrasound

09/01/2010

Question:

My daughter`s ultrasound has shown that the baby`s kidneys are abnormal. Both kidneys have cysts on them. The one kidney does not appear to be functioning. Will the cysts on the other kidney cause it to stop functioning as well. She is 28 weeks along in her pregnancy. What I have read online appears to be pretty grim. I am wondering if this a progressive type condition. Does the fact that both kidneys are cystic indicate that the remaining kidney is is danger of failing?

Answer:

This question is impossible to answer accurately without seeing the films. When cysts completely replace the kidney, that often is a "multicystic dysplastic kidney" and the kidney does not function. However, there are several other conditions in which cysts may occur in the kidney--polycystic kidney, duplication anomaly, and simple cysts, to name a few. In general, cystic disease does not worsen over time in utero.

In your daughter's ultrasound, an important predictive factor is the status of the amniotic fluid. If the volume of amniotic fluid is low at 28 weeks, often it is because the kidneys are not functioning well. On the other hand, if the volume of amniotic fluid is normal, then that is a sign that the kidney(s) has a reasonable amount of function. However, I re-emphasize, without personally reviewing the films, it is impossible to provide accurate information regarding the ultrasound.

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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