학술논문

Unilateral Multicystic Dysplastic Kidney Management: A National Survey.
Document Type
Article
Source
Clinical Pediatrics. May2024, Vol. 63 Issue 4, p482-487. 6p.
Subject
*KIDNEY function tests
*MEDICAL protocols
*DISEASE management
*VESICO-ureteral reflux
*PHYSICIANS' attitudes
*NEPHRECTOMY
*DESCRIPTIVE statistics
*CYSTIC kidney disease
*SURVEYS
*BLADDER radiography
*PHYSICIAN practice patterns
*PATIENT aftercare
*MEDICAL care costs
Language
ISSN
0009-9228
Abstract
Risks of contralateral kidney abnormalities and chronic kidney disease necessitate follow-up for unilateral multicystic dysplastic kidneys (MCDK). A nationwide survey of senior UK pediatricians was conducted. Of the 60 responses obtained, 62% routinely perform a dimercaptosuccinic acid scan to confirm diagnosis. Eight percent routinely perform a cystogram to investigate contralateral vesicoureteric reflux. Sixty-two percent would routinely measure renal function (frequency ranging from once only to "every 2 years"). Twenty-five percent recalled MCDK nephrectomy being performed within the previous 5 years. Respondents voiced concerns that national guidance may result in an overcautious approach but could balance consensus and safe variation, and offer families choice and reassurance. The mean estimated cost of follow-up from birth to 18 years ranged from £258 to £3854. Results demonstrate significant variation in management, highlighting the need for a clear pathway to decrease unwanted variability and to ensure those at high risk of renal sequelae are recognized early, without undue investigatory burden. [ABSTRACT FROM AUTHOR]