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Gonul Aydogan - One of the best experts on this subject based on the ideXlab platform.

  • Unilateral Multicystic Dysplastic Kidney: single-center experience
    Pediatric Nephrology, 2009
    Co-Authors: Aysel Kiyak, Alev Yilmaz, Pinar Turhan, Serdar Sander, Gulay Aydin, Gonul Aydogan
    Abstract:

    Multicystic Dysplastic Kidney (MCDK) is one of the most common renal abnormalities in children. The aim of our study was to evaluate the clinical course and outcome of patients with MCDK. Ninety pediatric patients with unilateral MCDK followed by the Pediatric Nephrology Department of Bakırkoy Maternity and Children’s Hospital between 1990 and 2007 were included in this retrospective study. The dimercaptosuccinic acid radionuclide scan revealed no function in MCDK in all of our patients. Voiding cystourethrogram was performed in all patients. Twenty patients (22.2%) had abnormalities in the contralateral Kidney. Nephrectomy was performed in 41 patients (45.5%). Twelve patients had undergone routine nephrectomy before 1996. Since then, patients have been followed up conservatively, and nephrectomy has been performed only when indicated. Indication of nephrectomy was arterial hypertension in 16 patients (23.1%), recurrent urinary tract infection (UTI) in 11 (15.9%), and severe abdominal pain in two (2.8%). Hypertension was noted within the first year of life in all patients except two. MCDK completely involuted in 39.3% within 48 months. There was no malignant transformation, proteinuria, or renal failure. In conclusion, hypertension is often noticed in infants with MCDK. Uninephrectomy leads to normalization. However, prospective studies are needed to exclude a spontaneous improvement of hypertension.

Eduardo A Oliveira - One of the best experts on this subject based on the ideXlab platform.

  • ultrasound progression of prenatally detected Multicystic Dysplastic Kidney
    Urology, 2006
    Co-Authors: Eli A S Rabelo, Eduardo A Oliveira, Jose Maria Penido Silva, Daniely S Oliveira, Enrico A Colosimo
    Abstract:

    Abstract Objectives To evaluate the sonographic involution of prenatally detected Multicystic Dysplastic Kidney (MCDK). Methods A total of 53 children with unilateral MCDK detected by prenatal ultrasonography between 1989 and 2004 were included in this analysis. All children received conservative management with follow-up visits every 6 months. Follow-up ultrasound examinations were performed at 6-month intervals during the first 2 years after birth and yearly thereafter. A linear mixed effect model was constructed, including MCDK length as the dependent variable and body size parameters and contralateral renal dimensions as independent variables. Results The mean follow-up time was 68 months. A total of 334 ultrasound scans were analyzed. The ultrasound scan demonstrated partial or total involution of the MCDK in 48 cases (91%). A consistent negative correlation was found among MCDK length, patient age, and body size parameters. As a whole, the MCDK length reduction was estimated to be 0.29 mm/mo. The rate of reduction was not constant over time and was intense during the first 30 months of age. According to the regression model, MCKD reduced in length by 0.80 mm/mo during the first 30 months of age, 0.26 mm between 30 and 84 months old, and 0.30 mm in children older than 84 months. Conclusions Our results suggest a clear tendency of MCDK to decrease in size, with the rate of the involution greater during the first 30 months than the rate in older children.

  • predictive factors of ultrasonographic involution of prenatally detected Multicystic Dysplastic Kidney
    The Journal of Urology, 2006
    Co-Authors: Eli A S Rabelo, Eduardo A Oliveira, Guilherme Souza Silva, Isabela Leite Pezzuti, Edson S Tatsuo
    Abstract:

    OBJECTIVE To evaluate possible predictive factors of involution on ultrasonography (US) or disappearance of a prenatally detected Multicystic Dysplastic Kidney (MCDK). PATIENTS AND METHODS Forty-five children with unilateral MCDK detected by prenatal ultrasonography between 1989 and 2002 were analysed. All patients except one had 99mTc isotopic scintigraphy to confirm the absence of renal function in the MCDK. All children were managed conservatively with follow-up visits every 6 months, with US 6-monthly during the first 2 years of life and yearly thereafter. Survival was analysed using the Kaplan-Meier method to evaluate the involution of the MCDK, with differences between subgroups assessed using the two-sided log-rank test. Cox's regression model was applied for the multivariate analysis. RESULTS The mean (range) follow-up was 50 (12–167)  months; in all, 279 ultrasonograms were taken, the mean (range) number per patient being 6 (3–10). US showed partial involution of the MCDK in 30 (67%) cases and complete involution in nine (20%). The absolute MCDK length remained almost unchanged in six children (13%). Univariate analysis showed that four variables were possibly associated with complete involution of the MCDK (gender, impalpable Kidney, renal length at admission using two thresholds, 62 and 78 mm). After adjusting by Cox's model only a renal length at diagnosis of <62 mm remained associated with complete involution (relative risk 8, 95% confidence interval 0.98–68; P = 0.05). CONCLUSION These results suggest that only a renal length of <62 mm on initial US was predictive of complete involution of the MCDK during the follow-up.

  • conservative management of Multicystic Dysplastic Kidney clinical course and ultrasound outcome
    Jornal De Pediatria, 2005
    Co-Authors: Eli A S Rabelo, Eduardo A Oliveira, Jose Maria Penido Silva, Maria Cândida Ferrarez Bouzada, Barbara C Sousa, Mirela N Almeida, Edson Samesima Tatsuo
    Abstract:

    OBJECTIVE The aim of this study was to describe the clinical course and ultrasound outcome of prenatally detected Multicystic Dysplastic Kidney. METHODS Fifty-three children with unilateral Multicystic Dysplastic Kidney detected by prenatal ultrasound between 1989 and 2004 were included in the analysis. All children were submitted to conservative management with follow-up visits every six months. Follow-up ultrasound examinations were performed at six-month intervals during the first two years of life and yearly thereafter. The following clinical parameters were evaluated: blood pressure, urinary tract infection, renal function, and growth. The following ultrasound parameters were evaluated: involution of Multicystic Dysplastic Kidney and contralateral renal growth. RESULTS The mean follow-up time was 68 months. Two children presented hypertension during follow-up and five had urinary tract infection (only one with recurrent episodes). There was no malignant degeneration of Multicystic Dysplastic Kidney. A total of 334 ultrasound scans were analyzed. US scan demonstrated involution of the Multicystic Dysplastic Kidney in 48 (90%) cases, including complete involution in nine (17%). The involution rate was faster in the first 30 months of life. There was progressive compensatory renal hypertrophy of the contralateral renal unit; the rate of growth was greater in the first 24 months of life. CONCLUSION The results of prolonged follow-up of children with conservatively managed Multicystic Dysplastic Kidney suggest that clinical approach is safe, the incidence of complications is small, and that there is a clear tendency for Multicystic Dysplastic Kidney to decrease in size. Our data also suggest that the involution rate of Multicystic Dysplastic Kidney as well as the growth of the contralateral Kidney is greater in the first 24 months of life.

  • spontaneous improvement of hypertension in Multicystic Dysplastic Kidney a case report
    Pediatric Nephrology, 2002
    Co-Authors: Eduardo A Oliveira, Eli A S Rabelo, Ana Cristina Simoes E Silva, Maria Tereza Freire Filgueiras, Alamanda Kfoury Pereira, Francesca M Mesquita
    Abstract:

    We report a case of transitory hypertension associated with unilateral Multicystic Dysplastic Kidney (MCDK). A newborn girl with MCDK, detected by prenatal ultrasonography, was conservatively treated and has been followed for 18 months at the Pediatric Nephrourology Unit (HC-Belo Horizonte, Brazil). Arterial hypertension was observed at about 4 months of age and was associated with high levels of plasma renin activity and circulating angiotensin, and also with changes in renal Doppler ultrasonography. For these reasons, a nephrectomy was initially proposed. However, a spontaneous improvement of blood pressure levels was noticed at about 10 months of age. Serial Doppler ultrasonography showed involution of the affected renal volume and decreased arterial flow. The anatomical improvement was observed simultaneously with normalization of the peripheral renin and angiotensin values. The literature is reviewed regarding the relationship between hypertension and MCDK.

  • Multicystic Dysplastic Kidney detected by fetal sonography conservative management and follow up
    Pediatric Surgery International, 2001
    Co-Authors: Eduardo A Oliveira, Eli A S Rabelo, Jose Maria Penido Silva, Jose Silverio S Diniz, Aranai S Vilasboas, Maria Tereza Freire Filgueiras
    Abstract:

    The most common cystic lesion recognized antenatally is Multicystic Dysplastic Kidney (MCDK). Recently, conservative management without nephrectomy has been advocated. The purpose of this study was to report our experience in the conservative management of unilateral MCDK. Between 1989 and 1997, 20 children with MCDK detected by prenatal ultrasonography (US) were prospectively followed. At birth, US confirmed the prenatal findings in all cases. All patients were submitted to radioisotope scans and a micturating cystogram. Follow-up US examinations were performed annually. Mean age at diagnosis during the prenatal period was 31 weeks of gestation (range 24-38). Median follow-up time was 33 months (range 7-91). Follow-up US was performed in 19 children; 13 (68%) showed partial involution, 4 (21%) complete involution, and 2 (11%) an increase in unit size. The mean age at complete or partial involution of the lesion was 18 months. No children developed hypertension or tumors, and all maintained normal growth. In conclusion, the natural history of MCDK is usually benign, and serial US examinations show that affected Kidneys frequently show involution with time.

Giampaolo Grisolia - One of the best experts on this subject based on the ideXlab platform.

Allison Zanno - One of the best experts on this subject based on the ideXlab platform.

  • Multicystic Dysplastic Kidney with mass effect in a neonate treated with nephrectomy case report
    Urology, 2021
    Co-Authors: Samuel Pettit, William J Devan, David J Chalmers, Allison Zanno
    Abstract:

    Multicystic Dysplastic Kidney is a developmental disease that results in a lobulated Kidney of noncommunicating cysts and abnormal parenchymal tissue. Dysplastic Kidneys are usually benign and often involute over time with conservative management. The second most common cause of palpable abdominal mass in a neonate, Multicystic Dysplastic Kidney can cause respiratory distress secondary to extrinsic compression. However, such cases are sparse. Here we present the case of an otherwise healthy term newborn with an exceptionally large MCDK requiring CPAP support and intubation. His respiratory distress improved immediately after nephrectomy. Communication about cases like this will inform management of future comparable cases.

Nobuhiko Okamoto - One of the best experts on this subject based on the ideXlab platform.