Cystic Diseases of the Kidney

Multicystic Dysplastic Kidney: Etiology and Diagnosis

Multicystic Dysplastic Kidney (MCDK) is a congenital disorder characterized by abnormal renal development, where the affected kidney is replaced by multiple non-functioning cysts. This condition is usually unilateral and diagnosed in infancy.

Etiology of MCDK

• Genetic Factors: Although MCDK is typically sporadic, some cases may be associated with genetic mutations affecting renal development.
• Obstructive Mechanisms: Early ureteral obstruction or abnormal differentiation of the metanephric blastema can lead to cyst formation.
• Teratogenic Influences: Certain environmental toxins and maternal drug exposure during pregnancy have been linked to kidney malformations.

Diagnosis of MCDK

Diagnosis is typically established via imaging studies, often performed due to abnormal prenatal ultrasound findings.

• Ultrasound: The primary diagnostic tool, revealing multiple cysts with absent normal renal parenchyma.
• CT or MRI: Used for further anatomical assessment and to rule out malignancies.
• Renal Scintigraphy: Confirms the absence of renal function in the affected kidney.

Prognosis and Management

MCDK often leads to compensatory hypertrophy of the contralateral kidney. Regular follow-ups, including blood pressure monitoring and renal function tests, are crucial to ensure healthy development.