Multicystic Dysplastic Kidney (MCDK): An Overview

Multicystic Dysplastic Kidney: Causes, Diagnosis, and Treatment

At its core, multicystic dysplastic kidney, or MCDK, is a congenital condition that generally gets diagnosed in infancy or even prenatally. Though the name may ring with a little complexity, comprehending MCDK, coupled with its causes, diagnostic procedures, treatment options, and management in general, will help parents and patients alike to go through the condition with increased confidence.

What is Multicystic Dysplastic Kidney?

 
MCDK, or multicystic dysplastic kidney, is a developmental abnormality wherein the proper development of the affected kidney does not occur during gestation. In the place of normal kidney tissue, the kidney is replaced with fluid-filled sacs or cysts of different sizes. Because it won't function properly, this results in what is called a non-functional kidney.

Most times, MCDK is unilateral, affecting only one kidney. However, in the most severe cases, it can affect both kidneys, known as bilateral. It is much more severe than the former.

How Common is MCDK?

MCDK is one of the most common congenital kidney abnormalities, with an occurrence of one in every 4,300 live births. It is seen more frequently in males and in 70% of people, currently overlaying an affected left kidney.

Causes of Multicystic Dysplastic Kidney

The exact aetiology of MCDK is still not known, although it is believed to result from problems during the early development of the urinary tract. Several factors may contribute to the occurrence of MCDK:

Genetic Factors

While MCDK itself is not usually inherited, there may well be some genetic predisposition to urinary tract anomalies. It can be but one part of a number of genetic syndromes in which MCDK is but one of several abnormalities occurring together.

Environmental Factors

Some environmental factors during pregnancy, such as exposure to certain toxins or infections, can cause MCDK. However, specific environmental causes have not been identified.

Sporadic Development

Most cases of MCDK are sporadic; there has been no known cause, genetic or environmental. It is simply one of those developmental anomalies that occurs in fetal growth.

Diagnosis of Multicystic Dysplastic Kidney

Diagnosis of MCDK is normally done prenatally through routine prenatal ultrasounds. Further imaging tests may be done if a doctor thinks that somebody has MCDK for the diagnosis of the presence of MCDK and to determine its severity.

Prenatal Ultrasound
If abnormal anatomy of the kidney has been noticed by the sonographer during a prenatal ultrasound scan, wherein multiple cysts are seen but no normally organized kidney tissue can be identified, MCDK may be suspected to be present, in which case follow-up ultrasounds may be indicated to monitor the condition throughout pregnancy.

Postnatal Ultrasound
A postnatal ultrasound is normally done after birth to confirm the diagnosis, which will help in evaluating the size and appearance of the cystic kidney and assessing the functioning of the other kidney.

Voiding Cystourethrogram (VCUG):
A voiding cystourethrogram may sometimes be conducted to diagnose vesicoureteral reflux, the condition wherein urine flows backwards or refluxed from the bladder into the ureters or the kidney. The test will also rule out other abnormalities in the urinary tract.

Nuclear Medicine Scan
A nuclear medicine scan, like a MAG3 scan, would be done to ascertain that the affected kidney is functioning normally and the other is a normal one.

Treatment of Multicystic Dysplastic Kidney

There is no cure for MCDK, as the affected kidney is non-functional and cannot be repaired. Treatment focuses on monitoring the condition and managing any associated complications.

Monitoring and Observation
In most cases of unilateral MCDK, the condition is managed with regular monitoring and observation. Periodic ultrasounds and check-ups with a pediatric nephrologist help ensure that the healthy kidney is functioning well and that no complications arise.

Surgical Removal
Surgically removing the affected kidney, known as nephrectomy, is rarely needed. It may be considered for pain, hypertension, or other complications that may arise from the cystic kidney. Most children with unilateral MCDK live healthy, normal lives with one functioning kidney.

Management of Complications

Associated complications, such as a urinary tract infection or hypertension, will be treated if present. UTIs can be treated with antibiotics, while hypertension will require medication.

Living with Multicystic Dysplastic Kidney

Living with MCDK, especially unilateral MCDK, does not much affect daily life. However, a few precautions and lifestyle modifications can be followed to keep the kidneys healthy and stay fit overall.

Regular Medical Check-ups
Follow-up with a healthcare professional on a regular basis is quite necessary to monitor the function of the remaining kidney and pick up any kind of abnormality at an early stage. These follow-ups normally involve blood pressure checks, urine testing, and ultrasounds.

Healthy Diet and Hydration
A healthy diet with plenty of fluids is important in supporting the function of your remaining kidney. A well-balanced diet that is rich in fruits, vegetables, and lean proteins and proper fluid intake helps to keep the residual kidney in health.

Avoiding Nephrotoxic Substances
Avoiding kidney-toxic substances should become part of daily life. That includes, but is not limited to, avoiding some over-the-counter medications like NSAIDs, and limiting consumption of protein or salt excessively. Patients always need to check with their provider before taking any medications or supplements.

Physical Activity
Promoting healthy and active living supports good health overall. In children or adults with unilateral MCDK, routine physical activity restriction is not necessary.

Education and Support
Educating oneself and members of the family about MCDK decreases anxiety and gives one a sense of understanding. Support groups and counselling may be beneficial for families coming to terms with the diagnosis.

School and Social Life
Most often, the school and social life of children diagnosed with MCDK in the antenatal or postnatal period is not restricted in any way. Notifying teachers and carers of the condition heighten vigilance but generally, no special treatment is needed for these children.

Summary

Though concerned, the multicystic dysplastic kidney is a congenital condition that can be managed with proper care and monitoring. Most of the people suffering from unilateral MCDK live perfectly healthy and normal lives with only one functioning kidney.

Early diagnosis with timely systematic follow-ups and a healthy lifestyle are very important for the proper management of the condition. Comprehending MCDK empowers parents and patients to make informed decisions about how to confidently deal with this condition en route to confronting its challenges.