Know about Unilateral renal agenesis

Know about Unilateral renal agenesis

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Know about Unilateral renal agenesis
Posted in 2013

Unilateral renal agenesis (URA) is defined as the one-sided congenital absence of renal tissue resulting from failure of embryonic kidney formation . Human renal development is initiated at the fifth gestational week and is characterized by highly orchestrated interactions between the outgrowing ureteric bud of the mesonephric duct and the metanephric mesenchyme. As a consequence, renal agenesis occurs when the ureteric bud fails to form the ureter, the renal pelvis and the collecting ducts and the renal mesenchyme to form nephrons

URA should be discriminated from abnormal or incomplete renal development leading to a non-functioning kidney, as can be identified in a multicystic dysplastic kidney (MCDK) or renal aplasia . With fetal ultrasonography screening routinely performed, clinicians are more often confronted with an apparent diagnosis of URA. Post-natal ultrasound, renal scintigraphy and/or magnetic resonance imaging can further discriminate between MCDK, renal aplasia or renal ectopia (i.e. pelvic kidney or cross-fused kidney). However, it must be noted that the diagnosis of ‘URA’ could derive from the spontaneous involution of the MCDK.

URA is often associated with congenital anomalies of the kidney and urinary tract (CAKUT) of the contralateral kidney , such as pelviureteric junction obstruction (PUJO) and vesicoureteral reflux (VUR). Furthermore, URA patients frequently have extra-renal anomalies, such as cardiac, genital or gastrointestinal malformations . Although studies confirm the association of URA with CAKUT and other malformations , the prevalences of these anomalies are not well established.

Assessment of the prevalence of associated malformations in URA may be important as it helps clinicians to ascertain a general and renal prognosis for patients with URA. Some authors report that URA is a more or less harmless congenital malformation], whereas a recent study demonstrated that 40–50% of adults with URA required dialysis by the age of 30 years. Although reported in a selected series of URA patients and thereby likely overestimating the true risk of end-stage renal disease, this impaired clinical outcome may be explained by the hyperfiltration hypothesis, which has been described by Brenner et al. more than three decades ago 

My advise
1..   Take necessary steps to avoid this problem to your child
2...  Develop Positive thinking and continue till delivery
3..   Follow healthy habits

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