Single Central Diagnosis And Treatment Of Congenital Dysplastic Kidney In Children

Objective: To investigate reasonable diagnosis and treatment of congenital dysplastic kidney(CDK)in children.Methods:Between January 2010 and November 2017,the Clinical data of 72 children(male 44 and female 28,ages ranged from 6 day to 14 years,mean 3.6 years)with congenital dysplastic kidney were retrospectively analyzed at this center.The involved side was left(n= 39)and right(n=29)and bilateral(n=4).The symptom with CDK in children include abdominal pain and abdominal mass and urinary incontinence and recurrent urinary tract infection,and so on.Whereas asymptom with CDK in children were diagnosised by antenatal or postnatal examination.All the patients underwent B-ultrasound examination.66 routine intravenous pyelography(IVP),27 routine MRI,10 routine MRI water imaging(magnetic resonance urography,MRU),including 3 MRI+MRU.56 routine retrograde pyelography(RP)examination,19 routine enhanced CT,1 routine CT urography(CTU),3 routine voiding cystourethrogram(VCU)examionation.Results: Among of 72 cases,40 cases CDK were diagnosised by renal B-ultrasound.And 7 cases CDK were diagnosised by IVP and 3 cases CDK were diagnosised by CT,5cases CDK were diagnosised by MRI and 10 cases CDK were diagnosised by MRU,1case CDK was diagnosised by CTU.The 4 cases of polycystic dysplasia were confirmed in intraoperative Whereas diagnosised renal hydronephrosis in preoperative.The 2 cases CDK were diagnosised in intraoperative with no CDK in Preoperative examination.The 8 cases CDK underwent surgical operation due to contralateral nephropathy [4 ureteral bladder replantation including 1 patient with posterior urethral valve resection due to bladder ureter junction obstruction(UBJO)and the other 4 cases Anderson-hynes with Uretero pelvic junction obstruction(UPJO)] Whereas 6 cases underwent no operation due to bilateral CDK.And 12 cases CDK with ipsilateral UPJO underwent Anderson-hynes and the rest 46 cases with CDK underwent nephroureterectomy.The 1 case accompanying with right ovarian multiple cyst was diagnosised in intraoperative during 15 cases laparoscopic nephroureterectomy and right ovarian multiple cyst was exfoliated at the same time.The rest cases recovery well with growing normal development except for1 case postoperative incontinence improved and 1 case contralateral kidney deteriorated to end-stage kidney during following up for 3 months to 7 years.Conclusions: To diagnosis early CDK by prenatal examination or routine physical examination with different clinical manifestations of CDK in hildren.B-ultrasonography and MRU are recommended for CDK at first.IVP and CT and RP are helpful in diagnosising CDK.Nephroureterectomy is effective surgery for CDK with normal contralateral renal function.