Renal Agenesis: Causes, Symptoms, Treatment and Cost

A congenital abnormality known as renal agenesis occurs when either one or both of a person's kidneys do not develop properly. It is a relatively uncommon disorder that only manifests itself in around one out of every three thousand live births.

There are two primary types of renal agenesis, which are known as unilateral and bilateral renal agenesis.

• Unilateral Renal Agenesis: When just one kidney does not develop normally, this condition is known as unilateral renal agenesis. In certain instances, the afflicted kidney could be partly formed but not functioning, but in others, it might not develop at all.
• Bilateral Renal Agenesis: The condition known as bilateral renal agenesis arises when both kidneys fail to mature correctly over the course of development. This is a far more dangerous problem, and if it is not treated appropriately, it may lead to complications that put the patient's life in danger.

There is a lot of mystery around this condition's precise origins. On the other hand, it is thought that a number of variables, both hereditary and environmental, are responsible for causing it.Chromosome abnormalities like trisomy 13 and 18 are potential risk factors for renal agenesis.

Intrauterine infections, certain medications taken during pregnancy, and parental consanguinity (being related by blood) also contribute to its major cause.

The most common symptom of Renal Agenesis is the absence of one or both kidneys.

Other symptoms may include:

• Abnormally small abdomen
• Low birth weight
• Hypertension
• Increased protein levels in the urine (proteinuria)
• Swelling in the hands and feet (edema) due to fluid retention
• Anemia
• Urinary tract infections due to stagnant urine
• Poor growth and development due to nutrient deficiencies

Because it is caused by hereditary causes, it is a rare disorder that cannot be avoided. However, pregnant women can reduce their risk for having a baby with this condition by consulting their doctor about genetic testing.

Risk also decreases by following a healthy lifestyle and avoiding certain environmental exposures. Furthermore, if parents have concerns about their baby's development, they may opt to undergo prenatal diagnosis.

A variety of tests are used to diagnose renal agenesis, including:

• Ultrasound: The kidneys and other organs are imaged using sound waves in this examination.
• MRI (magnetic resonance imaging): A strong magnetic field and radio waves are used in this examination to obtain detailed pictures of the kidneys and other organs.
• CT (computed tomography) scan: This scan produces comprehensive pictures of the kidneys and other organs using X-rays and a computer.
• Blood tests: These tests can measure levels of creatinine and urea in the blood, which are waste products produced by the kidneys. High levels of these substances can indicate a problem with kidney function.
• Urine tests: These tests can measure the levels of various substances in the urine, including proteins, electrolytes, and waste products. Abnormal levels of these substances can indicate a problem with kidney function.
• Renal function tests: These tests measure how well the kidneys are functioning by looking at how much blood is filtered by the kidneys and how much urine is produced.
• Genetic testing: In some cases, genetic testing may be done to identify the specific genetic cause of renal agenesis. This may enable medical professionals in determining the most appropriate course of therapy and care for the individual.

Renal agenesis can lead to a number of complications, including:

• High blood pressure: Without functional kidneys, the body is unable to regulate blood pressure properly, leading to high blood pressure.
• Fluid and electrolyte imbalances: The kidneys play a crucial role in regulating the balance of fluids and electrolytes in the body. Without functioning kidneys, this balance can become disrupted, leading to a number of problems.
• Anemia: The kidneys generate erythropoietin, a hormone that aids in the creation of red blood cells. The body may not create enough erythropoietin if the kidneys are not working properly, resulting in anaemia.
• Growth and development problems: In severe cases of renal agenesis, the lack of functional kidneys can lead to slowed growth and development.
• Increased risk of kidney infections: Without functioning kidneys, the body is unable to filter out bacteria and other infectious agents that may enter the urinary tract, increasing the risk of kidney infections.
• Dialysis or transplantation: In severe cases of renal agenesis, patients may need to undergo dialysis or a kidney transplant in order to survive.

• Herbs: Consume herbs such as Punarnava (Boerhavia diffusa), Gokshura (Tribulus terrestris), and Shatavari (Asparagus racemosus) to support healthy kidney function.
• Supplements: Take supplements of natural diuretics such as dandelion, horsetail, and nettle to flush out toxins from the body and promote healthy kidney function.
• Water: Drink plenty of fluids throughout the day to help your body flush out toxins more efficiently and maintain hydration in the body.
• Antioxidant reach food: Increase your intake of antioxidants by consuming foods like berries, dark leafy greens, sweet potatoes and squash which can help protect your kidneys from damage caused by free radicals.

• For people with renal agenesis, it is important to follow a low-sodium, low-protein diet.
• Fruits and vegetables, whole grains, lean proteins like chicken, fish, and eggs, andlow-fat dairy items like milk and yoghurt are also advised.
• Consume good fats like nuts and avocados.
• Consuming fiber-rich meals may also help to reduce the likelihood of constipation.
• Drinking enough of water throughout the day is also crucial to avoid dehydration.

The following foods should be avoided:

• Processed meats
• High sodium canned soups and processed food
• Fried foods
• Salty snacks (such as chips)
• High potassium fruits such as bananas and oranges
• Dairy products with a high phosphorus content (such as cheese or ice cream)
• Red meat
• Refined grains (like white bread or spaghetti)

Treatment for renal agenesis typically involves:

• Supportive Care: Patients with renal agenesis may require specialized nutrition and hydration support to help maintain their health.
• Dialysis: Dialysis is a medical procedure used to filter and purify the blood when kidney function is impaired. It can help remove waste products from the body that would otherwise accumulate due to poor kidney function.
• Renal transplant: The primary surgical treatment for renal agenesis is a renal transplant.
• Pyeloplasty: In some cases, a procedure called pyeloplasty may be used to create an artificial connection between the bladder and the ureter. This procedure is usually only performed if the patient has no other option, as it carries risks and can be difficult to perform.
• Lifestyle changes: lifestyle changes such as avoiding certain foods that can worsen symptoms, exercising regularly, maintaining a healthy weight, reducing stress levels, and avoiding exposure to toxins.
• Supplements: Omega-3 fatty acids, for example, may help lower inflammation linked with renal disease.
• Cognitive behavioral therapy (CBT): Supportive therapies such as cognitive behavioral therapy (CBT) can help manage emotions related to living with a chronic condition like renal agenesis.

It is usually treated by a pediatric nephrologist, a doctor who specializes in kidney care for children.

The best medicines for Renal Agenesis for preventing complications include:

• ACE inhibitors (angiotensin-converting enzyme inhibitors): These medications act by inhibiting angiotensin, a hormone that leads blood vessels to constrict and elevates blood pressure. Examples include lisinopril, ramipril, and enalapril.
• Angiotensin II receptor blockers (ARBs): These drugs inhibit the activity of angiotensin II, a hormone that constricts blood vessels and raises blood pressure. Losartan and valsartan are two examples.
• Calcium channel blockers: These drugs reduce the force of contraction of your heart muscle, allowing it to pump more easily and lowering your blood pressure. Examples include amlodipine, diltiazem, and verapamil.
• Diuretics: These medications help rid your body of excess salt and water, reducing the amount of fluid in your blood vessels and lowering your blood pressure. Examples include hydrochlorothiazide and furosemide.
• Beta-blockers: These medications slow down your heart rate by blocking certain hormones in your body that increase heart rate and raise your blood pressure. Examples include metoprolol, propranolol, atenolol, carvedilol, bisoprolol
• Antiinflammatory drugs: Non-steroidal anti-inflammatory drugs (NSAIDs) are medications that help reduce inflammation, swelling, and pain. Common NSAIDs used to treat renal agenesis include ibuprofen, naproxen, and aspirin.
• Corticosteroid: Corticosteroids such as prednisone or dexamethasone. These drugs can be taken orally or given as injections directly into the affected area.

• Renal Agenesis recovery period varies widely depending on the person and the extent of the ailment.
• Generally, those with milder forms of Renal Agenesis may not require any treatment, while those with more severe cases may need to undergo surgery or other procedures.
• Additionally, those requiring treatment will likely need to follow up with their doctor for regular check-ups and monitoring.
• Recovery time might range from weeks to months, based on the individual's circumstance.

The effects of renal agenesis treatment are not permanent. In certain circumstances, the illness may reoccur or problems associated with therapy may occur. Most individuals, however, can control their disease and live healthy lives with careful follow-up treatment.

In India, treatment for Renal Agenesis varies depending on the extent of the ailment and the person's health records.

Generally, treatment options may include dialysis, kidney transplant or supportive care.

The cost of these treatments in India can range from Rs. 7-9 lakhs for a kidney transplant to around Rs. 2-3 lakhs for dialysis and supportive care, depending on the patient's specific needs and circumstances.

The most common side effects of treatments for Renal Agenesis may include: nausea, vomiting, diarrhea, abdominal pain. Other symptoms includes fatigue, fever and infections.

If you are suffering from any complications relating to renal agenesis then you should consult a doctor nearby as they can have complications like 'High Blood pressure, anemia, kidney infection etc.' in which treatment course can range from a few months to years depending on the severity of the situation.