ABSTRACT
Kidneys are considered echogenic when they look brighter than the adjacent liver or spleen. The degree of echogenicity does not seem to be correlated with fetal outcome, and the difficulty is determining if the echogenic kidneys are a normal variant or an indicator of severe renal disease. The presence of positive family history of kidney disease is common in autosomal dominant polycystic kidney disease and, although typically the condition only manifests in adult life, early manifestation with pre-natal findings have been reported. The presence of oligo-anhydramnios, irrespective of the cause, dictates a poor prognosis. If the kidneys are enlarged and bright with oligohydramnios, the diagnosis of autosomal recessive polycystic kidney disease should be considered. The kidneys are enlarged as well as the other measurements but the amniotic fluid remains normal, overgrowth syndromes like Beckwith–Wiedemann and Perlman syndromes should be considered.
