Agenesis of the kidney in the fetus: what is it
Unfavorable external factors affecting a pregnant woman can sometimes, contrary to all protective mechanisms, lead to disorders of intrauterine development of the fetus. In a child, agenesis of the kidney (bilateral or, more often, unilateral) occurs in 1 case out of 1100-1200 births, and sometimes this pathology becomes a rather serious test for parents.
What is renal agenesis
This anomaly can be complete or partial. In the complete absence of a kidney, we are talking about agenesis. The presence of at least part of the organ indicates its aplasia. Very often, simultaneously with the absence of a kidney, underdevelopment, partial or complete absence of the ureter is noted. In the latter case, there is not even a mouth of the ureter in the bladder.
Most often, the organ is absent on the left side, although a right-sided anomaly is also possible. A bilateral process is extremely rare.
Symptoms of the anomaly
One-sided impairment may not manifest even until adulthood. It is often discovered accidentally during examination for other diseases. However, this is more relevant for adults. Modern screening methods make it possible to detect an abnormality in a fetus in the early stages of its development, although it is quite difficult.
When agenesis or aplasia of the kidney is suspected from birth, the presence of such accompanying anomalies should be taken into account, such as:
- agenesis of adrenal glands;
- anal atresia;
- vaginal atresia in girls;
- absence of vas deferens, testicle and its appendix in boys;
- violation of the development of the spine in the lumbar region.
These violations are much more noticeable and make an experienced doctor wonder if the baby has other abnormalities that are invisible during a routine examination.
During life, the second kidney, which increases in size even in the fetal period, takes over all the work of cleaning the blood from "garbage". This is called "compensatory hypertrophy." Its excessive volume increases the risk of various diseases. Some scientific data indicate that, over time, such people first develop glomerulopathy (deterioration of the filtration function of a single kidney), and then arterial hypertension. However, this theory is still being researched.
Bilateral renal agenesis is a fatal pathology in 100% of cases. The child is usually stillborn. Detection of such a pathology during pregnancy is a serious reason for a medical abortion. During ultrasound, pregnant women find:
- low water;
- absence of fetal bladder;
- absence of kidneys in the fetus.
Children with renal aplasia die in the first two days from respiratory failure, because their lungs do not develop due to hypothermia. There are known rare cases of normal development of the respiratory organs, but even then babies die from kidney failure in the first weeks of life.
Treatment of renal agenesis
With a bilateral anomaly, treatment is impossible. With a unilateral form of agenesis of the kidneys, the child does not need any intervention, since the existing organ fully copes with the function of blood purification. However, due to the fact that such children are in the risk group for various kidney diseases, they are taken into account early by a nephrologist or urologist. In the event of the development of infectious diseases, they are treated according to general rules, taking into account the fact of the presence of a single kidney. In case of injuries, the doctor is obliged to use all possible methods to save the organ (in healthy people, sometimes the removal of one of the kidneys when it is injured is the operation of choice).
Disability with agenesis of the kidney is not mandatory. Most often, such people live a completely normal life, without ever consulting a doctor with kidney diseases. However, if the kidney begins to fail to cope with its functions, the phenomena of kidney failure begin to increase. When this condition reaches the 2A degree (when the amount of creatinine in the blood plasma is 0.14-0.44 and the glomerular filtration rate is 20-50%), the patient has the right to undergo a medical examination and receive a disability group. If you have any questions, make an appointment with our specialists. Registration on the website Dobrobut.com and at the indicated phones.
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