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Paediatric Surgery

Multicystic Dysplastic Kidney Disease

Built from Puri — Pediatric Surgery and Pediatric Urology

What’s inside

8 sections · 46 slides

  1. 01

    Overview

    • What this deck will teach you

    1 slide

  2. 02

    Foundations

    What MCDK is, and where it sits among cystic kidneys

    • First, the big picture: cystic kidney diseases
    • Defining the multicystic dysplastic kidney (MCDK)
    • A short history: an old description that still holds

    3 slides

  3. 03

    How Common and Who Gets It

    What routine antenatal scanning revealed

    • Why MCDK suddenly looks more common
    • MCDK by the numbers
    • Who gets it: sex and side
    • Anomalies that travel with unilateral MCDK

    4 slides

  4. 04

    Pathology and Pathogenesis

    What it looks like, and why it forms

    • Macroscopic appearance: what the surgeon sees
    • Macroscopic multicystic dysplastic kidney
    • Microscopic hallmark: what the pathologist sees
    • Microscopic view of MCDK tissue
    • Why it forms: the developmental short-circuit
    • The genetic angle

    6 slides

  5. 05

    Classification and Associations

    Sorting MCDK into useful groups

    • Two ways to classify MCDK
    • Compensatory hypertrophy: the good-kidney safety net
    • What else MCDK associates with

    3 slides

  6. 06

    Presentation and Diagnosis

    From incidental scan finding to confirmed diagnosis

    • How MCDK shows up: then versus now
    • Diagnostic evaluation: ultrasound leads
    • Ultrasound features that suggest MCDK
    • Ultrasound of a multicystic dysplastic kidney
    • The main mimic, and how to tell them apart
    • Functional imaging: DMSA and MAG3

    6 slides

  7. 07

    Natural History

    Involution, cancer risk and blood pressure

    • Involution: the kidney that disappears
    • Can we predict which ones involute?
    • Malignant transformation: real risk or old fear?
    • Hypertension: another poorly defined, low risk

    4 slides

  8. 08

    Management

    Why the pendulum swung to conservative care

    • A paradigm shift over two decades
    • Why we still follow these children up
    • The VCUG debate
    • Indications for nephrectomy (removing the MCDK)
    • Simple versus complex MCDK: two management paths
    • Conclusions and future directions
    • Three things to remember
    • References (1/3)
    • References (2/3)
    • References (3/3)
    • Pediatric Surgery and Pediatric Urology

    11 slides