Unilateral Multicystic Dysplastic Kidney Management: A National Survey
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 confi...
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Veröffentlicht in: | Clinical pediatrics 2024-05, Vol.63 (4), p.482-487 |
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creator | Harmer, Matthew J. Stewart, Douglas J. Prasad, Pallavi Veligratli, Faidra Pickles, Charles Kim, Ji Soo Raja, Maduri |
description | 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. |
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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.</description><identifier>ISSN: 0009-9228</identifier><identifier>EISSN: 1938-2707</identifier><identifier>DOI: 10.1177/00099228231177808</identifier><identifier>PMID: 37278332</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Clinical decision making ; Complications ; Diagnostic tests ; Dimercaptosuccinic acid ; Humans ; Infant ; Kidney - diagnostic imaging ; Kidney diseases ; Kidneys ; Multicystic Dysplastic Kidney - diagnostic imaging ; Multicystic Dysplastic Kidney - therapy ; Nephrectomy ; Nephrectomy - methods ; Patient care planning ; Pediatrics ; Physicians ; Renal function ; Surveys ; Urinary Tract ; Vesico-Ureteral Reflux - complications</subject><ispartof>Clinical pediatrics, 2024-05, Vol.63 (4), p.482-487</ispartof><rights>The Author(s) 2023</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c368t-aa935d98f1ff206eb306f58a4d0f47727660cce1cef9e9b984d932277321d58f3</citedby><cites>FETCH-LOGICAL-c368t-aa935d98f1ff206eb306f58a4d0f47727660cce1cef9e9b984d932277321d58f3</cites><orcidid>0000-0003-2977-0263</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/00099228231177808$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/00099228231177808$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37278332$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Harmer, Matthew J.</creatorcontrib><creatorcontrib>Stewart, Douglas J.</creatorcontrib><creatorcontrib>Prasad, Pallavi</creatorcontrib><creatorcontrib>Veligratli, Faidra</creatorcontrib><creatorcontrib>Pickles, Charles</creatorcontrib><creatorcontrib>Kim, Ji Soo</creatorcontrib><creatorcontrib>Raja, Maduri</creatorcontrib><title>Unilateral Multicystic Dysplastic Kidney Management: A National Survey</title><title>Clinical pediatrics</title><addtitle>Clin Pediatr (Phila)</addtitle><description>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.</description><subject>Clinical decision making</subject><subject>Complications</subject><subject>Diagnostic tests</subject><subject>Dimercaptosuccinic acid</subject><subject>Humans</subject><subject>Infant</subject><subject>Kidney - diagnostic imaging</subject><subject>Kidney diseases</subject><subject>Kidneys</subject><subject>Multicystic Dysplastic Kidney - diagnostic imaging</subject><subject>Multicystic Dysplastic Kidney - therapy</subject><subject>Nephrectomy</subject><subject>Nephrectomy - methods</subject><subject>Patient care planning</subject><subject>Pediatrics</subject><subject>Physicians</subject><subject>Renal function</subject><subject>Surveys</subject><subject>Urinary Tract</subject><subject>Vesico-Ureteral Reflux - complications</subject><issn>0009-9228</issn><issn>1938-2707</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMtOwzAQRS0EoqXwAWxQJDZsUsaeJLbZVYUCooUFdB25iY1S5VHiBCl_j0MLSCA2fsjnXo8OIacUxpRyfgkAUjImGPZXAWKPDKlE4TMOfJ8M-3e_BwbkyNo1AEUI8ZAMkDMuENmQzJZllqtG1yr3Fm3eZEln3eJdd3aTq8_jQ5aWuvMWqlSvutBlc-VNvEfVZFXpQs9t_a67Y3JgVG71yW4fkeXs5mV658-fbu-nk7mfYCQaXymJYSqFocYwiPQKITKhUEEKJuBuqCiCJNE00UZquZIiSCUyxjkymobC4IhcbHs3dfXWatvERWYTneeq1FVr494FBIiCOvT8F7qu2tqNbGMElBQdKh1Ft1RSV9bW2sSbOitU3cUU4t5q_Eeyy5ztmttVodPvxJdVB4y3gHXGfr79v_EDnkSCeA</recordid><startdate>202405</startdate><enddate>202405</enddate><creator>Harmer, Matthew J.</creator><creator>Stewart, Douglas J.</creator><creator>Prasad, Pallavi</creator><creator>Veligratli, Faidra</creator><creator>Pickles, Charles</creator><creator>Kim, Ji Soo</creator><creator>Raja, Maduri</creator><general>SAGE Publications</general><general>Westminster Publications, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7QR</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2977-0263</orcidid></search><sort><creationdate>202405</creationdate><title>Unilateral Multicystic Dysplastic Kidney Management: A National Survey</title><author>Harmer, Matthew J. ; Stewart, Douglas J. ; Prasad, Pallavi ; Veligratli, Faidra ; Pickles, Charles ; Kim, Ji Soo ; Raja, Maduri</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c368t-aa935d98f1ff206eb306f58a4d0f47727660cce1cef9e9b984d932277321d58f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Clinical decision making</topic><topic>Complications</topic><topic>Diagnostic tests</topic><topic>Dimercaptosuccinic acid</topic><topic>Humans</topic><topic>Infant</topic><topic>Kidney - diagnostic imaging</topic><topic>Kidney diseases</topic><topic>Kidneys</topic><topic>Multicystic Dysplastic Kidney - diagnostic imaging</topic><topic>Multicystic Dysplastic Kidney - therapy</topic><topic>Nephrectomy</topic><topic>Nephrectomy - methods</topic><topic>Patient care planning</topic><topic>Pediatrics</topic><topic>Physicians</topic><topic>Renal function</topic><topic>Surveys</topic><topic>Urinary Tract</topic><topic>Vesico-Ureteral Reflux - complications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Harmer, Matthew J.</creatorcontrib><creatorcontrib>Stewart, Douglas J.</creatorcontrib><creatorcontrib>Prasad, Pallavi</creatorcontrib><creatorcontrib>Veligratli, Faidra</creatorcontrib><creatorcontrib>Pickles, Charles</creatorcontrib><creatorcontrib>Kim, Ji Soo</creatorcontrib><creatorcontrib>Raja, Maduri</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Harmer, Matthew J.</au><au>Stewart, Douglas J.</au><au>Prasad, Pallavi</au><au>Veligratli, Faidra</au><au>Pickles, Charles</au><au>Kim, Ji Soo</au><au>Raja, Maduri</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Unilateral Multicystic Dysplastic Kidney Management: A National Survey</atitle><jtitle>Clinical pediatrics</jtitle><addtitle>Clin Pediatr (Phila)</addtitle><date>2024-05</date><risdate>2024</risdate><volume>63</volume><issue>4</issue><spage>482</spage><epage>487</epage><pages>482-487</pages><issn>0009-9228</issn><eissn>1938-2707</eissn><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><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>37278332</pmid><doi>10.1177/00099228231177808</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-2977-0263</orcidid></addata></record> |
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subjects | Clinical decision making Complications Diagnostic tests Dimercaptosuccinic acid Humans Infant Kidney - diagnostic imaging Kidney diseases Kidneys Multicystic Dysplastic Kidney - diagnostic imaging Multicystic Dysplastic Kidney - therapy Nephrectomy Nephrectomy - methods Patient care planning Pediatrics Physicians Renal function Surveys Urinary Tract Vesico-Ureteral Reflux - complications |
title | Unilateral Multicystic Dysplastic Kidney Management: A National Survey |
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