KIDNEY CYSTS IN CHILD WITH ONE KIDNEY

[NANNY DI]

My 4 year old granddaughter was born with one kidney.  The other kidney was cystic and never developed. This was discovered in the 24th week of pregnancy. There were no complications during the pregnancy and she was a healthy infant. She has had no infections, reflux or problems, her blood tests and urine cultures are all normal.  On a routine ultasound, one cyst was found on the remaining kidney.  Kidney is functioning 100%.  An MRI was performed- it showed 3 cysts.  Kidney is normal size and is growing normally.  Her doctor suggested 3 possible diagnosis- benign cysts, Renal Dysplasia, or Polycystic Kidney Disease.  Her parents have tested negative for PKD and there is no family history of kidney disease. Should she have genetic testing to see if she has the gene for PKD?  If  she does, how did she get it when neither parent has it and no family history?  She has no symptoms nor does she have high blood pressure.  What should we do and what is the likely prognosis?  We are extremely worried. My daughter if fearful of having more children. Is Renal Dysplasia inherited?  How is that diagnosed and treated?  Can these cysts truly be benign?    Thanks, Nanny DI

[Kevin Pho, MD]

To answer your questions:
1) If PKD is indeed the diagnosis, obtaining a genetic test can be helpful to see if your granddaughter will pass on the gene.

2) If both parents have a recessive gene and pass it on, it can present in their daughter - in about 25 percent of cases.

3) Continuing to monitor the kidney function periodically can be done to monitor any decline.  

4) There may be a genetic component to renal dysplasia.  Diagnosing the exact cause and type of renal cysts can be helpful.   There is certainly a possibility that the cysts are benign.

These questions can be discussed with your granddaughter's pediatrician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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