Evaluation of children with multicystic dysplastic kidney: The role of recurrent urinary tract infections

Yıl 2026, Cilt: 9 Sayı: 1, 87 - 91, 17.03.2026

Mihriban İnözü , Kübra Çelegen , Özlem Yüksel Aksoy , Şevval İnce , Nesrin Taş , Betül Pehlivan Zorlu , Sare Gülfem Özlü , Fatma Şemsa Çaycı , Umut Selda Bayrakçı

https://doi.org/10.36516/jocass.1844491

https://izlik.org/JA48WG22JH

Öz

Purpose: Multicystic dysplastic kidney (MCDK) is the most common cystic renal disease in children and is often detected prenatally. This study evaluated the clinical features, associated anomalies, and renal outcomes of children with unilateral MCDK, focusing on the impact of recurrent urinary tract infections (UTIs) on renal function.
Methods: A retrospective review of 77 patients (aged 1–18 years) diagnosed with unilateral MCDK by ultrasonography between 2019 and 2024 was conducted. Demographic, clinical, and laboratory data were analyzed, including estimated glomerular filtration rate (eGFR), UTIs, hypertension, and contralateral compensatory hypertrophy.
Results: Of 77 patients, 64.9% were male and 55.8% had left-sided disease. Antenatal diagnosis was made in 77.9%, and 85.7% were asymptomatic. Urinary tract and extrarenal anomalies occurred in 27.3% and 40.3%, respectively. UTIs were observed in 31.2% and recurrent UTIs in 11.7%. Vesicoureteral reflux (VUR) was detected in 9.1% overall and in 33.3% of patients with recurrent UTIs (p=0.031). Mean follow-up was 7.2±4.4 years with a mean eGFR of 99.9±17.8 mL/min/1.73 m². Recurrent UTIs were more frequent in patients with eGFR <90 (p=0.018) and were associated with lower eGFR (p=0.021). Contralateral compensatory hypertrophy was present in 62.3% and correlated with older age and longer follow-up, but not with renal function.
Conclusions: Unilateral MCDK usually has a favorable prognosis. However, the high rate of associated anomalies and the link between recurrent UTIs and reduced eGFR underscore the need for long-term follow-up, early detection of VUR, and prompt UTI management to preserve renal function.

Anahtar Kelimeler

multicystic dysplastic kidney , urinary tract infection , vesicoureteral reflux , compensatory hypertrophy , renal function , children

Etik Beyan

Ethical approval for this study was obtained from the local ethics committee, and the study was conducted in accordance with the Declaration of Helsinki

Destekleyen Kurum

The authors declare that no financial support was received for this study

Teşekkür

The authors are grateful to all participants.

Multikistik displastik böbreği olan çocukların değerlendirilmesi: Tekrarlayan idrar yolu enfeksiyonlarının rolü

https://izlik.org/JA48WG22JH

Öz

Amaç: Multikistik displastik böbrek (MKDB), çocuklarda en sık kistik böbrek hastalığıdır ve sıklıkla prenatal dönemde saptanır. Bu çalışmada, unilateral MKDB’li çocukların klinik özellikleri, eşlik eden anomalileri ve renal sonuçları değerlendirilmiş; tekrarlayan idrar yolu enfeksiyonlarının (İYE) böbrek fonksiyonu üzerindeki etkisine odaklanılmıştır.
Yöntemler: 2019–2024 yılları arasında ultrasonografi ile unilateral MKDB tanısı alan 77 hastanın (1–18 yaş) retrospektif incelemesi yapıldı. Tahmini glomerüler filtrasyon hızı (eGFR), geçirilen İYE’ler, hipertansiyon ve karşı taraf böbrekte kompansatuvar hipertrofi varlığı dahil olmak üzere demografik, klinik ve laboratuvar verileri analiz edildi.
Bulgular: Yetmiş yedi hastanın %64,9’u erkekti ve %55,8’inde hastalık sol taraftaydı. Antenatal tanı %77,9 oranında konuldu ve hastaların %85,7’si asemptomatikti. Üriner sistem ve ekstrarenal anomaliler sırasıyla %27,3 ve %40,3 oranında görüldü. İYE %31,2, tekrarlayan İYE ise %11,7 oranında saptandı. Vezikoüreteral reflü (VUR) genel olarak %9,1 oranında ve tekrarlayan İYE’si olan hastaların %33,3’ünde tespit edildi (p=0,031). Ortalama izlem süresi 7,2±4,4 yıl olup, ortalama eGFR 99,9±17,8 mL/dk/1,73 m² idi. eGFR <90 olan hastalarda tekrarlayan İYE daha sık görüldü (p=0,018) ve tekrarlayan İYE daha düşük eGFR ile ilişkiliydi (p=0,021). Karşı taraf kompansatuvar hipertrofisi %62,3 oranında mevcuttu ve daha ileri yaş ile daha uzun izlem süresiyle ilişkiliydi; ancak böbrek fonksiyonu ile ilişkili değildi.
Sonuçlar: Unilateral MKDB genellikle iyi prognoza sahiptir. Ancak, eşlik eden anomalilerin yüksek oranı ve tekrarlayan İYE ile azalmış eGFR arasındaki anlamlı ilişki, böbrek fonksiyonunun korunması için uzun dönem izlemin gerekliliğini, VUR’un erken saptanması ve İYE’nin zamanında ve etkin bir şekilde tedavi edilmesi gerekliliğini ortaya koymaktadır.

Anahtar Kelimeler

Multikistik displastik böbrek , üriner sistem enfeksiyonu , vezikoüreteral reflü , kompansatuvar hipertrofi , böbrek fonksiyonu , çocuk

Etik Beyan

Bu retrospektif çalışma için yerel etik kuruldan onay alınmış olup, çalışma Helsinki Bildirgesi ilkelerine uygun olarak yürütülmüştür.

Destekleyen Kurum

Yazarlar, bu çalışma için herhangi bir finansal destek alınmadığını beyan eder

Teşekkür

Yazarlar, çalışmaya katılan tüm katılımcılara teşekkür eder.

Kaynakça

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