Child's kidney anagenesis, signs and causes of the disease, methods of treatment
Aging in a child is a complete absence of one or two kidneys. The defeat of two kidneys at once does not give chances to newborn children to survive. Agenesis of one can occur quite often - in 8% of cases of kidney diseases. Often, agenesis can be combined with other diseases of the urogenital system. Boys are twice as likely to get sick.
The cause of agenesis is a stroke that develops in the ureter's bud. Thus, there is an obstacle for the full development and arrangement of the kidney. As a rule, this process is one-sided and less often bilateral. The genesis of the right kidney in a child is diagnosed less often.
The remaining healthy kidney due to the exercise of the compensation function begins to hypertrophy and increases after one month of the child's life, but the propensity to such a process can be detected already with intrauterine development of the fetus. When carrying out an echographic examination, the enlarged organ does not differ in structure from a normal organ.
Symptomatology of pathology
The diagnosis of renal agenesis can be made as a result of computed tomography, urography or ultrasound examination. The fetal renal agenesis is manifested by the fact that the nose is too wide, the ears are lowered and deformed, the face swells, the frontal lobes protrude too much, the eyes are set very far.
Along with kidney aplasia, too often folding of the skin, deforming the legs of the baby, a violation of the size of the lungs and an increase in the volume of the abdomen.
Unilateral agenesis almost does not cause any manifestations of the disease, so it is diagnosed accidentally. Bilateral defeat is supplemented by increased blood pressure, frequent urination and kidney failure.
In the first days of a baby's life, the disease can manifest itself through the development of dehydration, vomiting, frequent urination, kidney failure.
One-sided form of agenesis is relatively common, and its main cause is the inferior formation or complete disappearance of the nephrogenic blastema, as well as an embryonic kidney consisting of wolf courses.
Species of pathology
- Unilateral lesion with absence of one kidney and retention of ureter. This developmental anomaly correlates with the first clinical type and is considered an innate pathology. When the fetus is affected by unilateral agenesis, the remaining healthy kidney takes on all the functional load and often increases in size for this reason. The increase in the number of renal structural elements makes it possible for a single healthy kidney to perform work immediately for two normal organs. The risk of developing serious complications arises in the event of injuries to the remaining healthy organ.
- Unilateral lesion with absence of one kidney and absence of ureter. This developmental anomaly manifests itself already at the first stages of embryonic formation of the urinary tract system. The main manifestation of this disease is the absence of the ureteral orifice. Due to some peculiarities of the structure of the men, agenesis may be accompanied by a lack of a duct, which removes the seminal fluid, as well as pathological changes in the seminal vesicles. All this causes pain in the groin, pain in the sacrum, pain in ejaculation, which can lead to violations of sexual functions.
- Bilateral lesion with absence of both kidneys. Such anomaly of development refers to the third clinical type. Children born with such a vice have practically no chance of survival. But there were cases when the child was full and born alive, although in the first days of his life he died from manifestations of insufficiency. In the modern world, medicine is constantly evolving, so there are technical opportunities for kidney transplantation for newborns, as well as for hemodialysis. It becomes important to timely diagnose bilateral agenesis and distinguish it from other malformations of the urinary system and kidneys.
Therapeutic process and diagnosis
Diagnosis of the disease is based on data obtained by ultrasound, showing complete absence of kidney from one side.
Children without a single organ should undergo a screening to determine the possible presence of additional developmental anomalies.
Patients are shown to perform cystoureterography because of the high likelihood of developing vesicoureteral reflux with the opposite side lesion.
Cytoscopy makes it possible to detect the absence of the ureteral orifice and atrophy in the corresponding side of the bladder triangle.
To assess the morphofunctional state of a healthy kidney, excretory urography is organized.
The choice of treatment of the patient will depend on the degree of disruption of the work of the organs. Most often, surgery is performed, namely, a kidney transplant, but at the same time, the patient will need antibiotic treatment.
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