Long-term urological follow-up of multicystic dysplastic kidneys: Is it still indicated in 2007?

OBJECTIVE

To determine whether the current indications for the long-term urological follow-up of children with multicystic dysplastic kidneys (MCDKs) are supported by the literature.

METHODS

The membership of the Pediatric Urologists of Canada was surveyed to determine if long-term urological follow-up was being performed, and if so, for what indications. A literature search using PubMed, EMBASE and a Conference Papers Index was performed to determine whether the indications listed were supported by the literature.

RESULTS

A response rate of 72% was achieved for the survey, with most respondents following children with MCDK long-term. The main indications for long-term follow-up were the increased risk of Wilms' tumour (54%) and hypertension (32%), observation of the contralateral kidney (43%) and involution of the MCDK (36%). The literature search did not support long-term urological follow-up for any of these indications, provided unilateral MCDK was an isolated genitourinary abnormality. Although it is rare, a primary care physician could monitor for hypertension.

CONCLUSION

Long-term urological follow-up of children with "simple MCDK" is not supported by the literature, provided the diagnosis has been confirmed with a follow-up renal ultrasound at 12-24 months. Blood pressure monitoring by a primary care physician is recommended.