‘My baby has only one kidney’

My 9-month-old baby has been suffering from some health issues and two weeks ago, it was discovered that he has only one kidney. Kindly educate us about this problem

Habashiyya V.

Thanks for your question and wishing your child speedy recovery. The condition is medically called Renal Agenesis, and is found in a newborn with one or both kidneys missing. Unilateral Renal Agenesis (URA) is the absence of one kidney, Bilateral Renal Agenesis (BRA) is the absence of both kidneys. It is a rare occurrence.

In healthy people, the kidneys:

•Produce urine, which removes urea, or liquid waste, from the blood.

•Keep a balance of sodium, potassium, and other electrolytes in the blood.

•Supply the hormone erythropoietin, helping red blood cells growth.

•Produce the hormone renin to help regulate blood pressure.

•Produce Vitamin D, which helps the body absorb calcium and phosphate from the gastrointestinal tract.

Everyone needs at least part of one kidney to survive. Without either kidney, the body cannot remove waste or water properly. This accumulation of waste and fluid can offset the balance of important chemicals in the blood, and lead to death without treatment.

What are the signs and symptoms of renal agenesis?

Both types of renal agenesis are associated with other birth defects, such as problems with the:

•Lungs and genitals and urinary tract.

•Stomach and intestines and heart.

•Muscles and bones and eyes and ears.

Babies born with Unilateral renal agenesis may have signs and symptoms at birth, in childhood, or not until later in life. Symptoms can include:

•High pressure

•Poorly kidney •Urine with protein or blood •Swelling in the face, hands or legs Babies born with Bilateral renal agenesis are very sick and do not usually live. They typically have distinct physical features that include:

•Widely separated eyes with skin folds over the eyelids

•Ears that are set low

•A nose that is pressed flat and broad

•A small chin

•Defects of the arms and legs

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Who is at risk of renal agenesis?

•Some studies have linked maternal diabetes, young maternal age, and alcohol use during pregnancy to renal agenesis. More recently, studies have shown pre-pregnancy obesity, alcohol use, and smoking to be linked to renal agenesis.

Binge drinking, or having more than four drinks over two hours, during the second month of pregnancy also increases risk.

• Environmental factors like maternal medication use, illegal drug use, or exposure to toxins or poisons during pregnancy may be factors.

What causes renal agenesis?

Both Unilateral renal agenesis and Bilateral renal agenesis occur when the uretic bud, also called the kidney bud, fails to develop at an early stage of fetal growth. The exact cause of renal agenesis in newborns is not known.

How to diagnose renal agenesis?

Renal agenesis is typically found during routine prenatal ultrasounds. If your doctor identifies Bilateral renal agenesis in your child, they can use a prenatal MRI to confirm the absence of both kidneys.

What are the treatment options?

•Most newborns with Unilateral renal agenesis have few limitations and live normally. The outlook depends on the health of the remaining kidney and the presence of other abnormalities. Once diagnosed, patients of any age with Unilateral renal agenesis need to have their blood pressure, urine, and blood tested annually to check kidney function.

•Bilateral renal agenesis is typically fatal within the first few days of a newborn’s life. Newborns usually die from underdeveloped lungs shortly after birth.

However, some newborns with

Bilateral renal agenesis survive. They must have long-term dialysis to do the work of their missing kidneys. Dialysis is a treatment that filters and purifies the blood using a machine. This helps keep your body in balance when the kidneys can’t do their job. The goal is to keep these infants alive with dialysis and other treatments until they grow strong enough to have kidney transplants.

Some preventive measures?

Women can lower the risk of renal agenesis by reducing exposure to possible environmental factors before and during pregnancy. These include use of alcohol and certain medications that can affect kidney development.