The multicystic dysplastic kidney in children.

Multicystic dysplastic kidney (MCDK) is the most common renal cystic disease in infancy and the second most common neonatal abdominal mass. It represents an extreme form of renal dysplasia. The key features in MCDK include variability in size, loss of kidney shape, absence of function and obstruction of ureter. Current management is still controversial. The prognosis is largely depended upon the problems of associated anomalies and the condition of the contralateral kidney. From September '82 to September '91, twelve patients with multicystic kidney have been treated at Taichung Veterans General Hospital. Ten of them received elective nephrectomy. The postoperative condition was uneventful. However, there was a high frequency of associated anomalies (41.6%) and pathologic contralateral kidney (50%). Two patients who refused operation were put on close observation and follow-up with ultrasound. During the surgical patients' follow-up period, one suffered from repeated urinary tract infection and the other died of multiple congenital anomalies.