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Multicystic Dysplastic Kidney-Top 10 Causes,Symptoms and Treatment Must Read

What is Multicystic Dysplastic Kidney

It is a type of condition occurs during fetal development of a baby at the age between (5 - 7) weeks. It occurs due to the abnormal formation of the kidney. In this type of case, the kidney consists of irregular cysts of different sizes.

The multicystic dysplastic kidney is a type of renal dysplasia and it is a cause of irregular mass lesions inside the kidney.



It belongs to the non-neoplastic cystic disease and the newborn baby has the characteristic of potter type 2 syndrome.

 The causes of the multicystic dysplastic kidney can we impute to genetics. Renal dysplasia can also be denoted as a genetic syndrome, which is the main reason for affecting the digestive tract, nervous system and mainly the urinary tract.

In normal cases, the function of the kidney is to filter the blood and remove waste products that are taken out of the body in the urine.

This urine collected in the ureter and then it moves to the bladder and drains out of the body through the urethra. but due to this abnormal formation of the kidney, it is possible to end up with a nonfunctioning kidney full of the cyst and damaged tissue.

CHANCES OF THIS MALFORMATION

The multicystic dysplastic kidney is a type of malformation affects 1 out of 3700 people. but it is also assumed that the number can be much higher because some people who have this disease never get diagnosed.

GENETIC TRAIT


It is also assumed that this disease runs in families because of genetic trait but most of the time majority cases occur as a sporadic event.

The process of formation of the kidney is one of the complex processes there are lots of steps that should get correct or else it will end up with any a malformation.

Some times because of infections and harmful rays can also damage the role of the kidney.

COMPLICATIONS AND PROBLEMS


  • Most of the time this disease not associated with any complications
  • There are some cases that are treatable structural abnormalities in the remaining kidney which causes blockage of urine and pain in urinary bladders. It patients with this disease should continue to follow up with kidney doctors.
  • The patient with this disease can likely have a normal life as this disease have a long term prognosis. 
  • Unfortunately, this disease has no way of prevention Multicystic dysplastic kidney occurs early in babies during fetal development.
  • Most of the time people get confused by the symptoms of Multicystic dysplasia by Autism. Though there are some common symptoms that do not mean one caused by another.
  • Most of the time this disease affects one kidney only in very rare cases it affects both of the kidneys. so time to time consultations with a doctor can help to get proper treatment of this disease through some recommended medicines and supplement 
Though there are no typical complications a patient with this disease can have some serious issues of urine blockage and pain. Doctors mainly provide some medicines for this disease but still, this disease is not curable because of the malformation of the kidney. 

REASONS

There are several causes behind this kidney dysplasia
  • It is assumed that genetic mutations can cause this kind of kidney malformation
  • Genetic syndromes can that can be a major impact behind the effect of multiple body system which can lead to abnormal grown or malformation. 
  • a baby can also be affected by the disease if his or her mother takes any kind of wrong medication during pregnancy.

CAUSES

The main cause behind renal dysplasia is as follows

  • Multicystic dysplasia is a kind of disease which occurs due to the malformation of the kidney. When one or both of the kidneys have any abnormal growth or don't form normally there will be a problem of urine drainage, this urine which is collected inside the kidney will lead to form multiple cysts.
  • Multiple renal dysplasias there is an abnormal induction of metanephric blastema by the ureteric bud.As there is a malformation in the ureteric bud the urinary tubules are not formed so the urine is collected in the kidney which leads to creating the fluid-filled cyst substance call cyst. These multiple cysts are disorderly arranged and normal renal parenchyma not found. calyces and pelvis cant be distinguished 


TYPES / CONDITIONS 

Renal dysplasia can be two types

A. Unilateral or single side 

B. Bilateral or both side



Unilateral condition

Most of the time this disease affects a single kidney, so another kidney works normally and does not affect the life of the patient. The patient has to take proper medications from the doctor as it is a long term prognosis 

Bilateral  condition

In very rare cases where both the kidneys were affected and completely damaged. the only treatment of this condition is dialysis and finally after sometimes renal transplant.

PATHOLOGIC FEATURES

Renal dysplasia is a variable and dysplastic cystic component. Their morphology shows abnormal cystic mass dysplastic kidneys have patent ureters with reform shape.

The congenital cystic anomaly of the kidney caused by abnormal metanephric differentiation, occurring by week 20 in utero Enlarged, cystic kidneys with disorganized parenchyma and numerous cysts

MICROSCOPIC FEATURE


Renal dysplasia is a dilated cyst and they are lined by flattened epithelium surrounded by connective tissue. characterized principally by primitive ducts with fibromuscular collar and lober unorganized pattern.

Around the primitive duct, spindle cell is arranged which are also known as a fibromuscular collar. The cyst which is found from the primitive duct can be large or small in size and there can be numbers of scarce, which leads to divergent microscopic features of multicystic call renal dysplasia.

The other pathologic findings are cartilage, bones basement membrane thickening of the primary duct, mental blastoma, and proliferation nerves.

With the comparison with normal nephrogenesis, dysplastic kidney shows abnormal differentiation of nephrons and composed of an abnormal grown metanephric element with an abnormal structural organization.



CLINICAL DESCRIPTION 

Bilateral renal dysplasia can be suspected or found by a routine CT scan or Ultrasound scan. this disease majorly detected around the 18 - 20th week of baby's gestation.

This type of case is considered lethal entity and most of the time these babies are terminate during fetal development. The baby with potter type 2 has several renal failure, limb anomalies, and features and generally dies shortly.


  • Most of the time the reason for this disease  cause of neonatal abdominal masses
  • Due to the presence of blastoma, there is a slight reason for cyst or tumors 

ETIOLOGY

MCDK generated from damaged nephrogenesis but the exact reason for the abnormal formation is still unknown to us. damaged form of nephrons results in uneven fetal urine flow from the very beginning of the infant development.

Mutations of the nuclear can lead to the cause of MCDK  and have only rarely been reported for the bilateral cases. MCDK is also linked to genetic disease and by using medications during pregnancy.

MEDICAL CARE

The nephrectomy in multicystic dysplasia plays an important role in the kidney (MCDK) which is controversial. The availability of recently modern ultrasonography, nephrectomy was often needed to establish the diagnosis.

A survey by Bloom revealed that 65% of pediatric urologists recommended nephrectomy (surgical removal of one or both kidneys) for a multicystic dysplastic kidney when compared with the recent data its shows that 40% of pediatric urologists recommend this process which is called nephrectomy.

Firstly, the main primary reasons to consider nephrectomy are to treat or prevent abdominal, urinary tract.

Treatment for Multicystic dysplastic kidney


The multicystic dysplastic kidney can be curable in many ways. we will discuss the treatment in three ways:-

Medical Care

Surgical Care

By maintaining diet and activity

So we all know if there is a chance of curing the disease by medicines then it's on the premature stage. So at first, we will discuss the remedy of MCDK ( Multicystic dysplastic kidney).

Infection (UTI), hypertension, or renal malignancy.

If a child suffers from constant back pain or abdominal pain then it has to believe that it is due to the pressure effects of the multicystic dysplastic kidney, so that the abnormal kidney should be removed.

If a child has any sign of and infection in any part of the urinary system which can be referred to as UTI, consider a nephrectomy only incase the UTI takes part in the kidney with a multicystic dysplastic kidney.

The presence of the problem when the flow of urine goes the wrong way called vesicoureteral reflux (VUR) causes the inflammation of the kidney or recurrent episodes of cystitis cannot be justified for nephrectomy in the multicystic dysplastic kidney.

The presence of a renal malignancy is a sign of nephrectomy.

The main topic that leads to a disagreement regarding the indications for nephrectomy is whether this procedure can find a remedy for renal malignancy.

Beckwith's mathematical analysis does not support nephrectomy which is based on the calculated incidence of Wilms Tumour which is rare kidney cancer, but the computation does not support the incidence of renal carcinoma.

The intervening stroma of a kidney is getting infected by a multicystic dysplastic kidney that might not go through complete involution and might supply a focus for malignant deterioration. However, there is no increased risk of Wilms tumor (kidney cancer) has been illustrating in patients with multicystic dysplastic kidney.

Some authors recommend nephrectomy only in patients who do not show involution over a defined period, such as the first 5 years of life. Because the peak incidence of Wilms tumor is in infancy and declines after age 5 years, this approach seems less scientific.

After some survey reports of insurance companies revealed that only fifteen percent issue life insurance if the multicystic dysplastic kidney is affected kidney is left in situ, later on, compared with seventy percent if the kidney is removed.

The main role of laparoscopic nephrectomy for a multicystic dysplastic kidney is not been discussed as this is controversial.

Individuals with multicystic dysplastic kidney should go through renal ultrasonography every six to twelve months until age five years or until involution or changes is noted.

So these are the medical treatment for Multicystic Renal Dysplastic. Now we will move on to surgical treatment.

SURGICAL CARE

Nephrectomy for metacystic dysplastic kidney is normally done as an inpatient process. However, it is reported that two to five cm incision for outpatient nephrectomy without the need for overnight hospitalization.

Laparoscopic nephrectomy plays a controversial role for metacystic dysplastic kidney. Consultations with a pediatric nephrologist and a pediatric urologist should be obtained.

Now going to a diet plan but before this one should stay in his positive mind. In nutrition, diet is the main source which sums up of food consumed by a person or other organism.

The word diet often suggested the use of eating a particular food for nutrition for health or weight-management reasons.

Although humans are omnivorous so the meat can be good for health which can give protein and can gain the power of the immune system, as there are different cultures and human being so there are different preferences for intaking food or some food taboos.

This may occur for some different tastes in human beings or maybe for some ethnic reasons. Whatever the individual should choose diet will be more or less healthy for every individual.

Diet for multicystic kidney dysplastic


A diet that reduces salt and protein to the recommended daily needs for age is suggested for almost every patient with only a single functional kidney.

The needs of lifestyle for patients with only one functional kidney include controlling a thin body habitus (constitution of the human body) and daily high impact exercise.
Drug treatment currently is not a component of the care for this condition.

Now for further outpatient care 

A patient with a multicystic dysplastic disease should go for a checkup at least once in 6 months and also if he or she face any kind of problem regarding the kidney.

A weekly check of blood pressure and hypertension is also necessary for patients of this disease. Regular consuming medicines at there own time is also one of the important things to take care of.

At the time of pregnancy, a woman with a record of renal dysplasia should have her blood pressure check regular basis and also her urine as well as her kidney condition should be checked repeatedly. These are the necessary steps that are to be followed.


THE COMPLICATIONS THAT CAN HAPPEN DUE TO RENAL DYSPLASTIC KIDNEY 

Irregular or unusual pain
Urinary system infection
Hypertension

In the report of metacystic kidney, it s found that mid hypertension in 7 out of 290 patients who where observes for 5 years.

The mean chances of children with unilateral(one side) metacystic dysplastic kidney develop hypertension within 7 seconds per 1000 patient. though the risk of hypertension in metacystic dysplastic kidney is very low it is still considered as a major problem for this patient as the blood pressure of these patients is high.

A test is performed to check the blood pressure of 25 metacystic dysplasia with ambulatory blood pressure monitor. 6 out of 25 patients had blood pressure and 75 % had combined daytime and nighttime hypertension and 3 had isolate night time hypertension.

Most of the children with contralateral urinary abnormalities have hypertension.

Most of the time it is found that patients with multicystic dysplastic kidneys have no radiologically incontrovertible blood flow.

However, the presence of congenital urinary abnormality such as renal dysplasia, the formation of pyelonephritic scar found in a contralateral kidney with VUR.

A malformation kidney is unlikely a reason for hypertension in early childhood. however, the presence of congenital urinary malformation such as renal dysplasia, the formation of a pyelonephritis scar is a contralateral kidney with VUR or the effects over time of hyperfiltration of the contralateral kidney are a potential cause of hypertension.

RENAL MALIGNANCY


Nephroblastoma(tumor) in a metacystic dysplastic kidney has been confirming of details information that in nine children with an average age of eight months.

Renal cell carcinoma which is also known as kidney cancer was reported in 10 patient at an age of 45 years and an embryonal tumor has been reported in 65 years old.

About 30 - 35% of the population is reported with nodular renal blastema. 7%  of the general population with metacystic dysplastic kidney and Wilms tumor is nearly 7 to 12 %.
As the increase of nodular renal blastema in metacystic dysplastic kidney might increase the risk for tumors.

The opening stroma of a kidney affected by metacystic kidney may not go through absolute changes and may provide a focus malignant decline. however, there is a low increase of Wilms tumor has been noticed in the metacystic dysplastic kidney.

A report has found that 30 studies demonstrated no case of Wilms tumor in about 1048 children with unilateral (one side ) metacystic dysplastic kidney 
Gastric outlet obstruction.

Due to feeding problems and respiratory difficulties because of the elevation of hemidiaphragm which are rarely reported, being a barrier to the outlet of gastric.


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