Siqueira Rabelo Eli A, Oliveira Eduardo A, Silva Jose Maria P, Oliveira Daniely S, Colosimo Enrico A
Department of Pediatrics, Pediatric Nephrourology Unit, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Urology. 2006 Nov;68(5):1098-102. doi: 10.1016/j.urology.2006.06.004. Epub 2006 Nov 7.
To evaluate the sonographic involution of prenatally detected multicystic dysplastic kidney (MCDK).
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.
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.
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.
评估产前检测到的多囊性发育不良肾(MCDK)的超声消退情况。
本分析纳入了1989年至2004年间经产前超声检查发现的53例单侧MCDK患儿。所有患儿均接受保守治疗,每6个月进行一次随访。出生后的前2年每6个月进行一次随访超声检查,此后每年进行一次。构建了一个线性混合效应模型,将MCDK长度作为因变量,身体大小参数和对侧肾脏尺寸作为自变量。
平均随访时间为68个月。共分析了334次超声扫描。超声扫描显示48例(91%)的MCDK部分或完全消退。在MCDK长度、患儿年龄和身体大小参数之间发现了一致的负相关。总体而言,MCDK长度减少估计为每月0.29毫米。减少率随时间并非恒定不变,在30个月龄前较为明显。根据回归模型,MCKD在30个月龄前长度每月减少0.80毫米,在30至84个月龄之间减少0.26毫米,在84个月龄以上的儿童中减少0.30毫米。
我们的结果表明MCDK有明显的尺寸减小趋势,其消退率在30个月龄前比大龄儿童更高。