Enlarged echogenic fetal kidneys are described as kidneys where the echogenicity of the entire kidney exceeds that of the liver. They can be associated with a number of pathologies that include:
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autosomal recessive polycystic kidney disease (ARPKD) 1
associated with severe oligohydramnios, very small or unfilled fetal urinary bladder, previously affected sibling, and normal kidneys in parents
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autosomal dominant polycystic kidney disease (ADPKD) 3
the large cysts may not form in utero and the kidneys may initially appear enlarged and echogenic
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in these overgrowth syndromes, echogenic fetal kidneys are associated with features of overgrowth with macroglossia and omphalocele
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renal dysplasia associated with encephalocele or holoprosencephaly
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renal dysplasia associated with trisomy 13
this is favoured by the presence of extra renal anomalies in the brain, limbs, heart or other systems
Treatment and prognosis
Isolated enlarged echogenic fetal kidneys with normal amniotic fluid index (AFI) carry a much better postpartum prognosis than the same finding with associated abnormal AFI or other associated findings 1.
See also
increased fetal renal echogenicity (without enlargement)
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