Infantile renal agenesis is the absence of one or both kidneys. It is a congenital and frequent disease, which is usually diagnosed during pregnancy. In the case of unilateral renal agenesis, children can have a totally normal life with one kidney, but visits to the pediatric nephrologist will have to be regular and carry out optimal follow-up.
Renal agenesis is the absence, at birth, of one kidney (unilateral) or of both kidneys (bilateral). Bilateral renal agenesis is very rare and tends not to be compatible with life. Unilateral renal agenesis is more frequent than is believed and occurs in somewhat less than 1 in 1000 births, occurring more frequently in Asia with a higher percentage in males. The absent kidney in most cases is the left one. It is proven that it has a high genetic and hereditary component and can be caused by mutations in many genes, such as RET (10q11.2), BMP4(14q22-q23), FRAS1 (4q21.21), FREM1 (9p22.3), or UPK3A (22q13.31)”.
Renal agenesis is a malformation that begins in the initial stage of the embryonic process, during pregnancy, and which, as the doctor tells us, results in the absence of one or both kidneys. The normal thing is that “thanks to check-ups during pregnancy, a prenatal diagnosis can be made in the second ultrasound. In principle, it will be the gynecologist who will carry out an ultrasound follow-up during the pregnancy and, successively, after delivery, the pediatric nephrologist will take care of the newborn”, the pediatrician tells us.
One of the curiosities of unilateral renal agenesis, which is the most frequent, is that the patient can have a completely normal life, since “the human body is capable of adapting, already during fetal life, to living with only one kidney. This is possible thanks to compensatory renal hypertrophy, that is, the ability of the single kidney to increase in size and duplicate its functions”, says Dr. Gentile. Sometimes, unilateral renal agenesis may even lack a diagnosis, since it is also a pathology lacking symptoms.
What are the risks for these children?
Although being able to live with only one kidney is a real possibility, since, as the pediatrician tells us, “most patients have a completely normal quality of life “, we must not forget the importance of the function of this kidney. the organ in the body, especially in children. Its main functions are:
- Filter impurities and excess fluids from the blood.
- produce urine
- It stimulates the production of red blood cells.
- Maintain normal blood pressure.
- Produce hormones that regulate the child’s body.
- Maintain a balance of minerals and blood and calcium levels.
The little ones who suffer from this disease are exposed to more risks, among them, “given the ‘overload’ of the function of the only kidney, over the years, a loss of protein can occur through the urine (proteinuria) and high blood pressure. Therefore, it is essential that a child with unilateral renal agenesis has an annual follow-up by pediatric nephrology, “warns the doctor.
Also, for these reasons, the child should lead a life as healthy as possible and “follow a diet that helps preserve a healthy kidney,” says the expert. “This diet usually includes foods low in phosphate and salt, avoiding protein abuse and minimal fat intake, ” he adds.
But, in addition, the child’s life habits must be also healthy, at all levels. Therefore, this should be treated as a family issue in which parents of children with only one kidney must take into account a series of warnings to carry out with their children so that they can have a better quality of life:
- When the child is old enough to understand, explain that he only has one kidney and the importance of taking care of it.
- A healthy and nutritious diet. Like all children, you can treat yourself from time to time, but in your day-to-day, you have to be strict for your good.
- Try, as far as possible, to avoid injuries to children. For any parent, this is unavoidable, but it is simply a question of taking special care with the activities that you carry out daily in your daily life, such as, for example, always wearing a seat belt or going in the child restraint seat (depending on your age), avoid contact or aggressive sports, beware of fights between siblings, etc…
- Share this information with the professionals of the school where the child is enrolled, so that they have their knowledge.