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When a baby is born without one kidney (kidney agenesis), it can function as he althy peers. The problem arises when this existing single kidney has a developmental defect or disease, and thus much less efficient.

Kidney agenesis( missing kidney ) is a not so rare problem, occurring in one person in 1100-1200. This problem is more common for women than for men (1.8: 1 ratio).

Why is a baby born without one kidney?

- The premature fetal organogenesis disorders that take place in the first trimester are to blame here. They consist in the lack of formation of the kidney bud or, more often, the ureteral donut, the arrival of which in the area of ​​the renal blastemis is a condition for its further development - explains Dr. Jerzy Czyż, a pediatric urologist and surgeon from the BIOS Center for Medical Diagnostics and Hematology and the Warsaw Children's Hospital. At the present stage, such defects are detected in the prenatal period, but this is not always the case. - Some time before the era of non-invasive imaging examinations, kidney agenesis was most often found at the time of autopsy. Currently, we find out about it accidentally during ultrasound of the abdominal cavity, performed for various, most often non-renal reasons, says Dr. Jerzy Czyż. - Or when diagnosing defects in the structure of the reproductive organs, which quite often accompany kidney agenesis, especially in women (25-50%).

When one kidney is missing and the other is ill …

If it turns out that the child has one kidney and after the tests (kidney scintigraphy) we are sure that it functions properly and takes over the role of the other - no need to worry. It is worse if the only one is burdened with disadvantages. In the case of agenesis of both kidneys, the prognosis is poor - in most cases, the fetus is dead or the death occurs soon after delivery. - pyelonephritis of the kidneys and ureters. A symptom of congenital defects of the urinary system may be less or no amniotic fluid (oligohydramnios).an inborn obstruction within the urinary tract that obstructs the outflow of urine, e.g. at the height of the pelvis with the ureter or the ureter with the bladder, or due to vesicoureteral drainage, or a defect of the urethra (e.g. posterior urethral valve). Congenital kidney defects also include hypoplasia (the kidney is of normal structure, but much smaller) and dysplasia (abnormal structure of the renal parenchyma). Children with kidney agenesis are usually under the constant supervision of specialists: a nephrologist or urologist. In order to confirm the diagnosis of kidney agenesis, it is necessary to perform imaging tests - ultrasound and kidney scintigraphy - If there is any problem with the second kidney, first of all it should be determined whether we are dealing with a congenital development disorder, such as hypoplasia or dysplasia, or secondary, caused by processes diseases occurring after the birth of the child - says Dr. Jerzy Czyż. - Malformations of the urinary tract, which may endanger the other kidney, should be ruled out and, if found, indications for possible treatment should be determined.

Important

If the child has kidney agenesis:

  • Make sure you drink enough - the kidney must be comfortable to work with,
  • teach your child to use the potty as soon as possible (preferably up to 1.5 years of age) instead of using disposable diapers,
  • Do not give, if there is no need, artificial vitamins - those from natural food provided in appropriate amounts, incl. fruits and vegetables are the best.

How to care for a kidney

Parents of children with one kidney are often concerned about the condition of the kidney because there is one kidney and they have to work for two. They pay more attention to the child's diet, make sure that they drink the right amount of fluids, consult a pediatrician or nephrologist every time they take a medicine or vitamins. There are, however, some observations indicating a greater frequency of arterial hypertension, proteinuria and features of mild renal failure in individuals with agenesis of one kidney - says Dr. Jerzy Czyż. - An overload of a single kidney leading to its failure cannot be ruled out either. But there is currently no convincing and conclusive evidence determining the causes and prevalence of features of renal failure in people born with a single kidney. However, due to the possible risk, some doctors advise against these people from engaging in contact and extreme sports due to the risk of injury and damage to the only kidney. - In my opinion, however, this is not justified,because we have vital but single organs, such as the brain and the liver. They should be protected in the same way - says Dr. Jerzy Czyż.

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