What is the multicystosis of the kidney in the fetus, the risks of development and treatment

  • What is the multicystosis of the kidney in the fetus, the risks of development and treatment

    Multicystosis of the kidney in the fetus or in another way mulkistozna dysplasia of the kidney is a congenital pathology of kidney formation, in which the kidney parenchyma is replaced by a large number of cystic formations of different sizes. In this case the kidney is not able to work normally.

    The size of the multicystic kidney can vary from a few centimeters to a large size, when the organ occupies half of the abdominal space.

    The disease is often combined with other pathologies of the urinary system, for example, with hydronephrosis of the second kidney, genital pathology, and the like.

    Multi-cystic kidney in a newborn includes potential risks of tumor growth from cells of abnormal kidney tissue. There is also a risk of developing persistent hypertension.

    Symptomatology and consequences of

    pathology This disease is usually one-sided, and bilateral lesions are diagnosed in 20% of cases and considered incompatible with life.is formed as a result of a violation of embryonic development in the fourth - sixth week of bearing a child.

    The basis of pathogenesis is atresia of the tuberculosis-ureteric compound during embryonic development. The incomplete fusion of the rudiment of the excretory apparatus with the rudiment of the secretory apparatus of the future kidney is performed. In addition, there may be an isolated development of the secretory apparatus of the kidney with simultaneous complete agenesis of its excretory components.

    In both cases, metanephrogenic tissue for some time produces urine, but it is not excreted, but accumulates in the tubules of the kidney, provoking their stretching and gradual transformation into cysts. With regard to the size and shape of the cysts, they can differ, their walls are made of fibrous tissue, and between the cysts is connective tissue, the ureter is developed inadequately or absent altogether.

    The abnormal kidney does not have clinical manifestations and is diagnosed accidentally during an ultrasound examination. Absence of symptoms complicates preoperative diagnosis of the disease.

    In some situations with multicystosis, some symptoms may appear, depending on the location of the lesion and its size. To the most frequent signs it is possible to carry pains of stupid character in the field of a loin or hypochondrium. There is also an increase in blood pressure, at times total hematuria begins, and the tumor itself is detected as a result of palpation. But palpation can not be perceived as a method of diagnosing this anomaly, because cystic formations can be confused with a real tumor or a lower segment of the kidney.

    In case of a breakthrough or suppuration of multicystosis, severe unbearable pain and inflammation begin.

    Often, cystic kidney neoplasms can form without affecting pathogenic factors, so for many years they have not shown themselves. In this regard, the danger of this disease depends on the specific site of the lesion.

    Diagnosis and treatment of pathology

    The most valuable diagnostic information for multicystosis can be obtained through ultrasound examination, which shows an increase or decrease in the size of the organ, and the renal parenchyma is almost completely replaced by numerous cysts of various sizes and shapes that in some places separate each otherfrom each other by dense partitions.

    Between the cysts is connective tissue, and it can contain calcifications or cartilage components. In modern medicine, because of the use of an antenatal ultrasound in diagnosis, the frequency of the diagnosis of multicystosis of the kidney in a child has significantly increased.

    The question of performing a surgical procedure for the detection of a multi-cystic kidney depends on the individual characteristics of the patient, usually this is the age group of children over the age of three. But there are situations when a nephrectomy may be required immediately after birth. The main indications for the operation at this age are large sizes of multicystic kidney, ultrasound and clinical symptoms of suppuration of cysts.

    Treatment of pathology

    Multicystosis of the left kidney in a fetus or right kidney causes a lot of disputes among doctors about the treatment. Some experts believe that the treatment process of multicystic kidney should be only operational, that is, the implementation of nephrectomy. At the same time, the main indication for surgical intervention is the difficulty of differentiation of the tumor-like process before the operation, the possibility of getting complications of the anomaly through inflammation, renal hypertension, the risk of rupture of the cysts with thin walls when getting injuries in the abdomen and waist.

    Other specialists are of the opinion that surgical intervention is required in case of defeat by any pathological process, such as urolithiasis, pyelonephritis, etc., multicystic kidney accompanied by pain and increased blood pressure.

    If a person has a second perfectly healthy kidney, disease predictions remain favorable. A special danger arises when the diagnosis of multicystosis of the kidney is incorrect when the patient develops an infantile or adolescent polycystosis, because in this pathology the realization of nephrectomy, that is, kidney removal, is prohibited. In this regard, doctors should be very attentive to the manifestations of pathology in newborns and conducting diagnostics for them.

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