In some cases, hypertension has been cured with nephrectomy of the MCDK, even if the kidney has shown involution on ultrasound, suggesting MCDK can be the primary etiology.
Hypertension can develop following remote nephrectomy of the MCDK, suggesting an abnormal contralateral kidney may be the etiology.
A review of published cohort studies of MCDK suggested the risk developing hypertension was no higher than that of the general pediatric population.
Multicystic dysplastic kidneys can be subclassified into "simple" and "complex" MCDK.
In "simple" MCDK, the risk of chronic renal insufficiency or end-stage renal disease at 5 years is nil.
In "complex" MCDK, the risk of chronic renal insufficiency or end-stage renal disease at 7 years is 29% and 21%, respectively.
Conclusion: The contralateral kidney in those with "simple" MCDK does not warrant urological follow-up.
Using only published reports of referred and live birth populations with MCDK where more than 90% of the patients with unilateral MCDK had a voiding cystogram, the percent with contralateral vesicoureteral reflux ranges from 4.
The risk of urinary tract infection in "simple" MCDK over 5 years is 7%.
The risk of urinary tract infection in "complex" MCDK is 29%.
Conclusion: The overall incidence of contralateral vesicoureteral reflux is higher in those with MCDK than the general population; however, the likeliness of having MCDK associated vesicoureteral reflux is significantly higher in those whose ultrasound shows contralateral renal abnormalities, in comparison to those who do not (Level 3 evidence) .
Confirm the diagnosis of MCDK is correct (Grade A recommendation)