Renal Agenesis

How is renal agenesis diagnosed?

Both types of renal agenesis can be identified in sonographic findings. Unilateral renal agenesis is found when the one developed kidney is larger than normal for the gestational age. Hypertension can also develop due to this anomaly, leading to diagnosis and requiring postnatal follow-up examinations.

Bilateral renal agenesis can be observed through sonographic findings that detail complete or severe depletion of amniotic fluid levels at 14 to 16 weeks. The inability to visualize the fetal bladder after 16 weeks of pregnancy should prompt further investigation for bilateral renal agenesis.

As a parent, receiving the news that your child may be missing both kidneys can be devastating. Even a diagnosis of unilateral renal agenesis can be worrisome, but the Colorado Fetal Care Center is a national leader in diagnosing and treating both types of renal agenesis.

Treatment for renal agenesis depends on the severity and type (unilateral or bilateral). For both types of agenesis, the standard treatment protocol involves monitoring the baby with numerous ultrasounds and planning delivery at the Colorado Fetal Care Center. While C-sections are not usually required to deliver babies with renal agenesis, immediate access to our care team after birth is essential to guarantee the best outcomes.

Bilateral renal agenesis treatment

Babies missing both kidneys cannot survive without treatment but the only available treatment is experimental.

Once diagnosed through a prenatal ultrasound, this defect can be addressed in utero with a series of amnioinfusions. This means that physicians inject saline solution into the amniotic sac to help the baby's lungs develop. Once the lungs start to develop, some stress is taken off the baby's system and he or she may be able to survive once outside the womb. The first known baby to survive bilateral renal agenesis did so in 2013 as a result of this new treatment. Two years later, she received a kidney transplant.

The Colorado Fetal Care Center offers a special amnioport procedure to facilitate amnioinfusion and to avoid repeated, potentially risky injections. Once the baby is born, he or she will be dependent upon dialysis until a kidney transplant can be attempted, usually at 1 year or older. The ability to offer dialysis after birth depends on the baby's size, weight and gestational age.

Unilateral renal agenesis treatment

Most babies who are missing just one kidney have no other symptoms, as that one organ grows large enough to perform the duties of both. However, infants with unilateral renal agenesis can have hypertension (high blood pressure) and may be born prematurely.

What is the prognosis for babies with bilateral renal agenesis?

In 2013, the first known baby to survive bilateral renal agenesis provided hope for all families who face this severe diagnosis. In that case, in utero injections of saline solution restored amniotic fluid and allowed the lungs to develop. Once born, the baby was dependent on dialysis for three years, until her father donated her a kidney.