SOVREMENNAYA PEDIATRIYA.2016.3(75):129-131; doi10.15574/SP.2016.75.129 

Diagnostic and treatment of multycystic displastic kidney in infants 

Spakhi O. V., Kokorkin O. D.

Zaporozhye State Medical University, Ukraine 

Multycystic renal dysplasia (MRD) occurs in 20% of cystic kidney abnormalities structure, data presented flaw thin-walled cysts of varying size, between which there is no parenchyma. According, to the literature the frequency of unilateral destruction — 1:4000, bilateral — 1:36,000 newborns. The basic method of verification multycystic renal dysplasia today — is a prenatal ultrasound diagnosis.

Objective: to study the efficiency of various methods of diagnosis and treatment of kidney multycystic dysplasia in infants.

Materials and methods: observed and examined 25 children with MCD: 11 (44%) girls and 14 (56%) boys. Distribution of children in groups was as follows: the main group — 15 children who are diagnosed prenatally MCD verified according to a screening ultrasound, the average dates of which amounted to 23±0.5 weeks gestation. The control group consisted of 10 patients who diagnosed MCD installed in the presence of recurrent pyelonephritis the results of ultrasound. Patients in the control group there was no documentation of prenatal ultrasound screening. In 80% of cases diagnosed MCD set at the time of treatment to the clinic with symptoms of pyelonephritis.

Results and discussion as the results of the study, the control group fatal organ operations. Success in 3 (30%) children. The main indication for surgery was the presence of recurrent pyelonephritis on the background of cystic — ureter reflux III level in the affected kidney. In 70% of children in the control group observed of hipovascularisation , with preservation of renal blood flow in the main and segmental arteries. In such cases, follow-up using tactics that paid off in most cases, reduce urinary tract dilatation in the absence of pyelonephritis recurrence over the next year of observation.

Conclusions the use of MRI for early differential diagnosis of multycystic renal dysplasia impaired upper urinary tract accompanied by severe abdominal expansion system increases the efficiency of detection of defects to 95%. Dynamic observation in children with prenatally diagnosed MDC justified and 80% of the allowed refrain from fatal organ operation.

Keywords: multicystic renal dysplasia, children, diagnosis, treatment.

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