🧬 Chapter 574 · Congenital Anomalies and Dysgenesis of the Kidneys

Nelson Textbook of Pediatrics 22nd Edition | Renal agenesis, dysplasia, multicystic dysplastic kidney (MCDK), hypoplasia, horseshoe kidney, renal cysts, and associated syndromes. Embryology, clinical presentation, imaging, management, and long-term outcomes.

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📋 30 Clinical Scenarios — Congenital Anomalies & Dysgenesis of the Kidneys

📇 High‑Yield Review Cards (Kidney Dysgenesis)

🩺 Clinical Recognition: Renal Anomalies & Dysgenesis

Select a presentation for diagnostic clues and management.

📋 Stepwise Approach to Congenital Kidney Anomalies

🔑 Key Principles — Nelson Ch 574
• Renal agenesis: Unilateral (1/450-1000 births) often associated with VACTERL, MRKH, Zinner syndrome. Contralateral hypertrophy.
• MCDK: Most common abdominal mass in newborn; cysts regress by age 7; risk of HTN (0.2-1.2%) and Wilms tumor (~1/1200).
• Horseshoe kidney: 1/400-500, higher risk of UPJ obstruction, stones, Wilms tumor (4x).
• Renal dysplasia/hypoplasia: Abnormal metanephric differentiation; oligomeganephronia → ESRD.
• Follow-up solitary kidney: Periodic BP, urinalysis, avoid contact sports? AAP allows sports, counsel about injury risk.

    ⚡ Reflex Prompts — Clinical Decisions in Renal Dysgenesis

    📖 Summary: Congenital Anomalies & Dysgenesis of Kidneys — Nelson Ch 574