The Multicystic Kidney

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Abstract
When an abdominal mass is found in a newborn it is likely to be a multicystic kidney. This asymptomatic mass is diagnosed in 60% of the children within the 1st yr of life. Two forms can be identified: the large multicystic kidney, tending to have a normal contralateral kidney; and the small multicystic kidney, which has a high incidence of contralateral renal anomalies and other congenital anomalies. The use of sonography has improved the diagnostic accuracy of this condition, B-mode sonography being superior to the A-mode technique. In a survey of 136 urologists selected because of their pediatric experience, 75% believed that an accurate diagnosis could be made non-operatively. However, 25% reported an unexpected operative finding on at least 1 occasion, usually hydronephrosis. Hypertension, infection and manifestations of pressure attributed to the multicystic kidney were reported by 35% of the respondents. Surgical exploration with removal of the abnormal kidney was considered mandatory by 56% of the respondents, while 44% believed that today an operation is no longer required.sbd.statistics that represent a change in attitude toward this condition. However, the ability to diagnose this condition accurately needs to be proved before this non-surgical approach can be adapted for each child. Moreover, if a child with this condition does not undergo an operation the parents should be advised of the possibility of problems stemming from the continued presence of the multicystic kidney in later years.

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