Renal dysplasia is a congenital condition where one or both kidneys do not develop normally. Instead of forming healthy kidney tissue, parts of the kidney are replaced with abnormal structures such as cysts, fibrous tissue, or poorly developed nephrons. Dysplastic kidneys may vary widely in severity—from mild changes that do not affect kidney function to severe forms where the kidney is small, malformed, and non-functional.
In many cases, dysplastic kidneys are associated with other urinary tract abnormalities, such as obstruction, vesicoureteric reflux, or ureteral malformations. The condition is usually detected on prenatal ultrasound when a kidney appears small, irregular, or cystic. After birth, further imaging helps confirm the diagnosis.
Symptoms depend on whether one or both kidneys are affected. If only one kidney is dysplastic, the other kidney often grows larger and functions normally. Most children in such cases do not experience any symptoms and lead normal lives. When both kidneys are dysplastic, kidney function may be significantly compromised, leading to problems with fluid balance, blood pressure, electrolyte regulation, and waste elimination.
Diagnosis involves ultrasound, renal scans, and blood tests to measure kidney function. In severe bilateral cases, newborns may present with breathing difficulty due to enlarged kidneys, poor feeding, vomiting, or failure to thrive. High blood pressure is another possible complication in older infants and children.
Treatment depends on severity. A mildly dysplastic kidney usually just needs regular monitoring to ensure it does not cause problems such as infections or high blood pressure. In some cases, the affected kidney may shrink over time. If the dysplastic kidney is causing recurrent infections or hypertension, surgical removal may be considered. For children with both kidneys affected, treatment focuses on managing kidney failure through medications, dietary adjustments, and sometimes dialysis or transplant.
Long-term outlook varies. Children with a single dysplastic kidney often grow normally with no restrictions, provided the other kidney is healthy. Those with bilateral renal dysplasia require lifelong nephrology care.
