Children's Hospital Colorado

Dysplastic Kidneys

What are dysplastic kidneys?

Dysplastic kidneys (also known as kidney dysplasia) are kidneys that did not develop properly during pregnancy. The kidneys may be a different size and shape than average kidneys and they often also have fluid-filled sacs called cysts. The cysts prevent the kidney from working normally. Dysplastic kidneys can have various degrees of function, ranging from mildly to severely decreased function, which requires medical treatment. A multicystic dysplastic kidney (MCDK) is a type of dysplastic kidney that has no or minimal function and is often covered in cysts.

Your child may have one dysplastic kidney, with the other one being healthy, or they can have two dysplastic kidneys. When both kidneys are affected, there is a higher risk of kidney disease because there is no healthy kidney to "make up" for the dysplastic kidney.

What causes dysplastic kidneys?

In developing babies, kidney development happens in a series of stages. Occasionally, this process is altered or disrupted by unnoticed and unexplained events that cause a dysplastic kidney. These events can sometimes be linked to an altered gene that is passed down from one parent. One recognized cause of dysplastic kidneys is the use of certain blood pressure medications during pregnancy.

Dysplastic kidneys can occur in a child as a single condition, or they can be part of a larger condition that also affects other organs. Congenital abnormalities of the kidneys and the urinary tract or CAKUT, are a group of conditions often associated with dysplastic kidneys in addition to an abnormally developed lower urinary tract. In other cases, dysplastic kidneys can be found in combination with malformations that affect both the urinary tract and other organ systems such as the genitalia, the heart or the lower digestive tract.

Who gets dysplastic kidneys?

Most often, the development of dysplastic kidneys is a random event that can occur across all genders and ethnicities and is not tied to events that occurred during pregnancy. Dysplastic kidneys can also be part of malformation syndromes that have specific underlying genetic defects called mutations.

What are the signs and symptoms of dysplastic kidneys?

If kidneys are dysplastic but are still functioning, there may not be any signs or symptoms. Once dysplastic kidneys begin losing function or have minimal function, your child may show signs of fatigue, loss of appetite, increased or decreased urination, nausea, pale skin, swelling of the face and legs, and headaches.

What tests are used to diagnose dysplastic kidneys?

At Children's Hospital Colorado, your child's doctor typically makes an initial dysplastic kidney diagnosis using ultrasound imaging. Blood and urine tests are then used to assess how well the kidney is functioning. Based on the results of these tests, your child's medical team will develop a comprehensive treatment plan.

Why choose us for dysplastic kidney treatment?

Our pediatric kidney care team has vast experience in caring for children with all types of kidney disorders, including dysplastic kidneys. Our multidisciplinary team is made up of doctors, nurses, dietitians, social workers and other pediatric professionals that provide child- and family-centered care for a range of conditions involving the kidneys. We also work closely with our Colorado Fetal Care Center in an effort to detect kidney issues before birth. If we find that the dysplastic kidneys are associated with CAKUT, we collaborate with our Department of Pediatric Urology to decide on the best treatment plan.

How are dysplastic kidneys treated?

Dysplastic kidneys can be managed, but there is no possibility of curing them to the point that they become fully functioning, healthy kidneys again. Treatment depends on how mild or severe your child's condition is.

Mild cases

A mild case of dysplastic kidneys can mean that only one kidney is affected and the other is healthy. If the heathy kidney is functioning well enough, your child may not need treatment of any kind.

Severe cases

The treatment of more extensive dysplastic kidneys depends on what the kidney function is. Significantly decreased kidney function will require treatment for associated complications such as anemia (low red blood cells), bone disease, high blood pressure and an excess of protein in the urine. If the dysplastic kidneys show severely low function, treatment may require dialysis or kidney transplantation.

Treating associated complications

  • Anemia (low red blood cell count): Anemia usually results in low red blood cell counts. This can be treated by increasing iron and vitamin intake, as well as some hormones that help with red blood cell production. Fatigue is the most common symptom of anemia.
  • Bone disease: Children with dysplastic kidneys can also get bone disease, also known as mineral bone disease. We typically treat this with medications and various vitamins that help to increase bone density and make them stronger.
  • High blood pressure and an excess of protein in the urine: If your child is experiencing decreased kidney function, high blood pressure or proteinuria (high amount of proteins in the urine), doctors often recommend medications. Medications may slow the progression of kidney disease, which may result in requiring dialysis or kidney transplantation.

Why choose us for dysplastic kidneys treatment?

Pediatric experts in The Kidney Center at Children's Colorado have vast experience diagnosing and treating dysplastic kidneys in children. This experience ranges from consultations for parents whose baby has kidney cysts on prenatal ultrasounds, often in our Fetal Care Center, to providing dialysis and kidney transplantation through our Pediatric Kidney Transplant Program.

For children who have dysplastic kidneys that require dialysis or transplantation, we offer the only dedicated pediatric dialysis facility and the only Pediatric Kidney Transplant Program in the Rocky Mountain region. Our Kidney Transplant Program is also one of the biggest in the country. Additionally, we collaborate with the adult nephrology division at the University of Colorado, which gives us access to state-of-the-art treatments and research studies.

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) research creates knowledge about and treatments for diseases such as dysplastic kidneys that are among the most chronic, costly and consequential for patients, their families and the nation.