Adverse external factors affecting a pregnant woman, sometimes, contrary to all protective mechanisms, can lead to disorders of fetal development. In a child, the agenesis of the kidney (bilateral or, more often, unilateral) occurs in 1 case from 1100-1200 births, and sometimes this pathology becomes a very serious test for parents.
Unilateral disturbance may not appear even until adulthood. Often it is found accidentally during the examination for other diseases. However, this is more relevant for adults. Modern screening methods can detect abnormalities in the fetus in the early stages of its development, although it is quite difficult. If agenesis or aplasia of the kidney from birth is suspected, the presence of such concomitant abnormalities as:
These disorders are much more noticeable and make an experienced doctor think - whether the baby has other abnormalities, invisible during a routine examination. During life all work on clearing of blood of "garbage" is undertaken by the second kidney which in the intrauterine period increases in the sizes. This is called "compensatory hypertrophy". Excessive volume increases the risk of various diseases. Some scientific evidence suggests that over time, such people develop first glomerulopathy (deterioration of the filtration function of a single kidney), and then hypertension. However, this theory is still being studied. Bilateral renal agenesis is a fatal pathology in 100% of cases. A baby is usually born dead. Detection of such pathology during pregnancy is a serious reason for medical abortion.
Children with renal aplasia die in the first two days from respiratory failure, because due to low water they do not develop lungs. Rare cases of normal respiratory development are known, but even then babies die from kidney failure in the first weeks of life.
At a bilateral anomaly treatment is impossible. With a unilateral form of agenesis of the kidneys, the child does not need any intervention, because the existing organ fully copes with the function of blood purification. However, due to the fact that such children are at risk for various kidney diseases, they are early registered by a nephrologist or urologist. In case of development of infectious diseases they are treated according to the general rules, taking into account the fact of existence of a single kidney. At injuries the doctor is obliged to use all possible methods to save an organ (at healthy people sometimes removal of one of kidneys at its injury is operation of choice). Disability in renal agenesis is not required. Most often, such people live a completely normal life without ever seeing a doctor with kidney disease. However, if the kidney begins to fail in its functions, the phenomena of renal failure begin to increase. When this condition reaches 2A-degree (with the amount of creatinine in blood plasma 0.14-0.44 and glomerular filtration rate - 20-50%), the patient has the right to undergo a medical examination and receive a disability group.
Date of publication 2019 - 2020
