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Pediatric Nephrology

, Volume 34, Issue 2, pp 295–299 | Cite as

Necessity of performing voiding cystourethrography for children with unilateral multicystic dysplastic kidney

  • Kazuna Yamamoto
  • Koichi KameiEmail author
  • Mai Sato
  • Masao Ogura
  • Mari Suzuki
  • Yuichi Hasegawa
  • Katsuhiko Ueoka
  • Shuichi Ito
  • Kenji Ishikura
Original Article

Abstract

Background

The purpose of this study was to resolve the clinical question as to whether all patients with unilateral multicystic dysplastic kidney (MCDK) should receive voiding cystourethrography (VCUG).

Methods

This is a retrospective study using cross-sectional analysis. Seventy-five children with unilateral MCDK were enrolled, excluding patients with other genetic or chromosome abnormalities, spinal cord diseases, or anal atresia. We reviewed their records from medical charts and calculated risk factors for abnormal VCUG using multivariate logistic regression analysis.

Results

Abnormal VCUG findings were present in 24 of 75 patients (32.0%), specifically, vesicoureteral reflux (VUR) in 8 (10.6%), including high-grade VUR in 2 (2.7%), and only lower urinary tract or bladder disease in 16 (21.3%). In multivariate analysis, only abnormal findings by ultrasonography was an independent risk factor for abnormal VCUG findings with statistical significance in multivariate analysis (OR 6.57; 95% CI 1.99–26.26; P = 0.002). When we excluded five patients who showed similar findings by ultrasonography and VCUG, abnormal findings by ultrasonography were again calculated as an independent risk factor (OR 4.44; 95% CI 1.26–28.42; P = 0.02). Sensitivity, specificity, positive predictive value, and negative predictive value of abnormal findings by ultrasonography to predict urologic anomalies by VCUG in these children were 83%, 59%, 49%, and 88%, respectively. Two children required a third ultrasonography to detect abnormal findings.

Conclusions

We can select, using only abnormal findings by ultrasonography, children with unilateral MCDK who should undergo VCUG. We would also like to emphasize that ultrasonography should be performed repeatedly to detect congenital anomalies of the urinary tract.

Keywords

Multicystic dysplastic kidney (MCDK) Voiding cystourethrography (VCUG) Vesicoureteral reflux (VUR) Congenital anomalies of the kidney and urinary tract (CAKUT) Ultrasonography Children 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The design and execution of this study were in accordance with the ethical standards of the Declaration of Helsinki. The protocol was approved by the Ethics Committee of the National Center for Child Health and Development (No. 1372).

Informed consent

For this type of study, formal informed consent is not required.

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Copyright information

© IPNA 2018

Authors and Affiliations

  • Kazuna Yamamoto
    • 1
    • 2
  • Koichi Kamei
    • 1
    Email author
  • Mai Sato
    • 1
  • Masao Ogura
    • 1
  • Mari Suzuki
    • 3
  • Yuichi Hasegawa
    • 3
  • Katsuhiko Ueoka
    • 3
  • Shuichi Ito
    • 1
    • 4
  • Kenji Ishikura
    • 1
  1. 1.Division of Nephrology and RheumatologyNational Center for Child Health and DevelopmentTokyoJapan
  2. 2.Division of PediatricsShiga University of Medical ScienceOtsuJapan
  3. 3.Division of UrologyNational Center for Child Health and DevelopmentTokyoJapan
  4. 4.Department of Pediatrics, Graduate School of MedicineYokohama City University School of MedicineYokohamaJapan

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