Eur J Pediatr Surg 2017; 27(06): 533-537
DOI: 10.1055/s-0037-1599837
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Early Nephrectomy in Unilateral Multicystic Dysplastic Kidney in Children Cures Hypertension Early: An Observation

Basant Kumar1, Vijai Datta Upadhyaya1, Manish Kumar Gupta1, Laxmi Kant Bharti2, Ram Nawal Rao3, Sheo Kumar4
  • 1Department of Pediatric Surgical Superspeciality, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  • 2Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  • 3Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  • 4Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
Further Information

Publication History

24 October 2016

30 January 2017

Publication Date:
27 March 2017 (eFirst)

Abstract

Objective Surgery is still indicated as the treatment of choice in subset of patients with unilateral multicystic dysplastic kidney (UMCDK) because of its potential complications and malignant change. The purpose of this study is to present our observation that early nephrectomy may cure hypertension early in children with UMCDK and review the literature.

Materials and Methods We report here four children (two males and two females) with antenatally diagnosed UMCDK with hypertension, treated in the past 4 years. All have antenatal diagnosis of UMCDK and referred to us after their birth. Diagnosis of hypertension (blood pressure > 95th percentile) was made after 3 months of follow-up in all patients. Nephrectomy was performed in all children in variable time duration. Hypertension, urinary tract infection, and desire of parents were the main indication of surgery.

Results All children showed decrease in the size of their dysplastic kidney with time, but hypertension was persistent and needed antihypertensive drugs; even increase in the doses in successive follow-up. After nephrectomy, three children who were operated early got cured having normal blood pressure within variable time duration, while a child, operated late, still had high blood pressure and needed antihypertensive drugs.

Conclusion Early nephrectomy in recently diagnosed hypertension in UMCDK is advisable and can cure hypertension early.

Levels of Evidence The level of evidence is IV (case series with no comparison group).