Kidney Dysplasia

Overview

Kidney dysplasia means a kidney did not form normally before birth. The kidney may be small, or it may have fluid-filled pockets called cysts. It can affect one kidney or both. It is not cancer, and it is not caused by anything a parent did or did not do.

It is uncommon overall. One-sided kidney dysplasia is one of the more common kidney problems seen on pregnancy ultrasound.

It can affect anyone. It is usually found in babies and young children, often before birth. Some people with mild one-sided dysplasia are not found until later in life.

Symptoms

Common symptoms

• Many people have no symptoms, especially when only one kidney is affected.
• High blood pressure.
• Urinary tract infections, which can cause burning when passing urine, fever, or back pain.
• Protein in the urine, found on a urine test.
• Swelling in the face, legs, or belly.
• Feeling tired, or poor growth in children.

Symptoms in children

• Found on a pregnancy ultrasound before birth.
• Fever, poor feeding, irritability, or vomiting with a urinary infection.
• Poor weight gain or growth.
• Swelling or a lump in the belly.
• High blood pressure.
• In severe cases, a newborn may have trouble breathing or make very little urine.

Symptoms in older adults

• Often found by chance during tests for another health problem.
• High blood pressure.
• Urinary tract infections.
• Protein or blood in the urine.
• Mild changes in kidney function on blood tests.
• Side or back pain, though this is less common.

Causes

Main causes

• Kidney dysplasia happens when kidney tissue does not form normally in the womb. The kidney may be small or have fluid-filled pockets called cysts.
• It is not cancer. It is not caused by anything the parent did or did not do.
• It often happens with other urinary tract problems, such as a blockage or urine flowing backward.
• Sometimes it is part of a genetic syndrome.

Risk factors

• A family history of kidney dysplasia or a genetic syndrome.
• Being born with other problems in the urinary tract.
• Certain genetic conditions.
• Sometimes no clear risk factor is found.

When to see a doctor

See a doctor urgently if:

• Fever with burning or pain when passing urine, or back pain.
• Blood in the urine.
• Much less urine than usual.
• New swelling of the face, legs, or belly.
• A blood pressure reading that is much higher than usual, with headache or vision changes.
• Vomiting and unable to keep fluids down.

Book a routine appointment if:

• Your baby had a kidney problem seen on pregnancy ultrasound.
• You have a family history of kidney dysplasia or a genetic kidney condition.
• You have been told you have one small or cystic kidney.
• You have high blood pressure or repeat urinary infections.

Diagnosis

A doctor may first see it on a pregnancy ultrasound. After birth, the care team uses tests to check kidney size, kidney function, blood pressure, and urine flow.

Tests that may be done

• Ultrasound, which uses sound waves to make a picture of the kidneys.
• Blood tests to check kidney function and salt levels.
• Urine tests to look for infection or protein.
• Blood pressure checks.
• Special scans such as a DMSA scan, which shows how well each kidney works, or an MRI.
• A VCUG test, which uses X-rays to see if urine flows backward from the bladder to the kidneys.
• Genetic counseling or testing if a genetic syndrome is suspected.

What to expect at your appointment

Your child may see a kidney specialist. Some children need only a few checks; others need regular follow-up. Tests are chosen based on age, symptoms, and test results.

Treatment

Kidney dysplasia cannot be cured, but it can be monitored and managed. The goal is to protect healthy kidney tissue, keep blood pressure in a safe range, treat infections, and support growth. Care is tailored to each person.

Self-care at home

• Go to all follow-up visits and blood pressure checks.
• Check with a pharmacist before using over-the-counter pain relievers, herbal products, or supplements, because some can harm the kidneys.
• Drink enough fluid, but follow any fluid advice your care team gives you.
• Eat a balanced diet.
• Stay active.
• Do not smoke, and keep children away from secondhand smoke.
• Check blood pressure at home if your care team asks you to.

Medical treatments

If one kidney is affected and the other is healthy, many people need only regular check-ups. If problems occur, treatment may include medicines to control blood pressure, medicines to treat infection, and support for nutrition and growth. If kidney function becomes low, the care team may discuss kidney replacement treatments such as dialysis or transplant. Only your care team can decide what is right for you.

When is surgery considered?

Surgery may be needed if a blockage or severe urine reflux is damaging the kidney, or if a very large or repeatedly infected kidney is causing problems. Sometimes a badly affected kidney is removed. The care team will explain the benefits and risks.

Living with this condition

Life often continues much like it does for other children and adults. You may have regular clinic visits, blood pressure checks, and urine tests. Keep a simple record of appointments and test results. Ask your care team what to do if your child gets a fever or passes less urine.

Lifestyle tips

• Stay at a healthy weight.
• Be active most days.
• Do not smoke, and avoid secondhand smoke.
• Limit alcohol.
• Take medicines only as advised.
• Keep vaccines up to date.

Diet and exercise

Eat regular, balanced meals with fruits, vegetables, whole grains, and protein. Limit salt if your care team advises. Drink enough water, but follow any fluid advice you are given. Exercise most days if you can; it helps blood pressure and heart health. A dietitian can help if kidney function is lower.

Mental health and emotional wellbeing

It is normal to feel worried, sad, or overwhelmed. Children may feel different from friends or tired of appointments. Parents and caregivers can feel stressed too. Talk with your care team about counseling or support. If you or your child has thoughts of self-harm, call your local emergency number or a local crisis service right away.

Prevention

Kidney dysplasia cannot usually be prevented because it starts before birth. Good prenatal care and early follow-up can help find problems and reduce complications. Nothing a parent did caused it.

Vaccines

Keep up with routine vaccines and any vaccines your care team recommends, especially if kidney function is reduced.

Screening programmes

Pregnancy ultrasound can find some kidney problems before birth. If you have a family history of kidney dysplasia or a genetic syndrome, ask about genetic counseling. People with known dysplasia need regular blood pressure and kidney checks.

Complications

If left untreated

• High blood pressure.
• Urinary tract infections.
• Chronic kidney disease or kidney failure, especially if both kidneys are affected.
• Poor growth in children.
• Fluid, salt, or acid balance problems.
• In severe cases before birth, low amniotic fluid can affect lung development.

Long-term outlook

The outlook is often good, especially with one affected kidney. Many people live full, active lives with regular check-ups. If both kidneys are affected, more care may be needed, but early monitoring and treatment can help protect health.

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