Kidney Dysplasia

By Jeff Damm

Kidney dysplasia is a disease where the internal structures of one or both of the fetus’ kidneys do not mature normally  in the womb. During normal maturity, 2 thin tubes of muscle known as ureters develop in the kidneys and stem out to create a network of minute structures known as tubules [1].

The tubules gather urine as the fetus develops in the womb. In kidney dysplasia disease,  the tubules are incapacitated to stem out completely. Urine that normally flows via the tubules has nowhere to be directed [2].Urine gathers inside the attacked kidney and creates a fluid-filled substance known as cysts.

The cysts substitute normal kidney tissue and limit the kidney from operating as expected.  It is very devastating to note that many babies born with kidney dysplasia do not survive at birth. In rare cases, the babies who survive from this disease need a serious diagnosis by a specialist [3].This includes:

  • Blood-filtering diagnosis known as dialysis.
  • A kidney transplant.

Kids with dysplasia in only 1 kidney have a normal functionality of kidney because the other kidney is unaffected. The children with kidney dysplasia in both kidneys may not need a transplant or a dialysis for a couple of years. Kidney dysplasia is also known as multicystic dysplastic or renal dysplasia.

The Nature and Functionality of Kidneys

The kidneys are 2 bean-sized organs, each approximately the size of a fist. They are positioned below the ribcage, one on each side of the spine positioned on the right and on the left. Normally, the 2 kidneys filter around 120 to 150 quarts of blood to create approximately 1-2 quarts of the urine, daily, which is comprised of extra fluid and waste [4].

Kids produce less urine compared to adults – the amount produced is determined by  the age. The urine moves from the kidneys to the bladder via the 2 ureters, 1 on every side of the bladder. The role of the bladder is to store urine.  

The muscles of the wall bladder are relaxed while the bladder receives urine. As the bladder gets filled with urine, the signals are transmitted to the brain to send an important message that an individual needs to go to the toilet. When the bladder drains the urine out of the body via a tube called the urethra, positioned at the bottom of the bladder, an individual feels relaxed.

Causes of Dysplasia

  • Acquired factors can contribute to kidney dysplasia disease. Genes passed by parents to children can determine the kid’s traits. In some instances parents pass genes that are mutated, causing kidney dysplasia disease [5].
  • Acquired syndromes can affect various body systems which can result in kidney dysplasia. A syndrome is a combination of conditions or symptoms that may be unrelated yet are speculated to contain a similar genetic cause. A kid with kidney dysplasia because of the genetic syndrome probably also might have challenges of the skeleton, muscles, digestive tract, heart, nervous system, blood vessels, or any other sections of the urinary tract.
  • A kid may have kidney dysplasia if his or her mother takes specific prescription treatment at pregnancy, like drugs used to treat high blood pressure or seizures. A woman who illegally uses prohibited drugs such as cocaine can result in kidney dysplasia in her unborn kid.

The Commonality of Kidney Dysplasia

Kidney dysplasia is a common disease. According to statistics,  dysplasia affects approximately 1 in 4, 000 kids. These statistics given may be fallible because some persons with kidney dysplasia never turn up to be treated in health centers that are recognized.  Around half of the kids treated with this illness suffer from urinary tract deficiencies.

Prevalence of Kidney Dysplasia

Kids who are more probable to get kidney dysplasia include the following:

  • Parents who have the genetic traits for the condition of this disease.
  • Genetic syndromes that affect different body organs.
  • Mothers who take certain kind of drugs during pregnancy or are using  illegal drugs like cocaine.

Symptoms and signs of Kidney Dysplasia Disease

A large number of kids with kidney dysplasia illness may have an enlarged kidney at birth and this causes pain automatically [6].

Complications of Kidney Dysplasia

  • Hydronephrosis of the functioning kidney: a kid with kidney dysplasia in one kidney only might suffer from other urinary tract defects. When other deficiencies in the urinary tract block the movement of urine, the urine backs up and results to the swelling of the kidney and also to the ureters a condition known as hydronephrosis. If left undiagnosed, hydronephrosis can cause a lot of harm by incapacitating the kidney to filter the blood [7]. This  can cause chronic kidney disease (CKD) and failure of the kidney.
  • A urinary tract contamination.  A urine blockage may trigger a kid’s chance of forming a UTI. Recurring UTIs can lead to the damage of the kidney.
  • High blood pressure.
  • A higher risk of  kidney cancer.

Treatment of Kidney Dysplasia

Expert specialists may manage to treat kidney dysplasia after diagnosing it during a woman’s pregnancy by use of fetal ultrasound, called a fetal sonogram. An ultrasound uses a gadget, known as a transducer that bounces safely on a human body, painless waves sound organs to form a picture of the structure [8].

Fetal ultrasound is a checkup done in the period of pregnancy to form pictures of the fetus in the womb. An individual does not need anesthesia for this process. Frequently medical specialists diagnose this disease after birth through an evaluation of the child.

However, children should have regular checkups that include the following:

  • Testing the blood pressure.
  • Checking the blood to gauge kidney functionality.
  • Examination of urine for albumin, a protein usually frequently found in the blood.  Albumin in the urine is an indication of kidney damage.
  • Carrying out regular ultrasounds to monitor the affected kidney and to be sure the kidney is healthy and growing naturally.  

References

  1. Bearman, S.B., Hine, P.L., Sanders, R.E. Multicystic kidney: a sonographic pattern. Radiology 2015
  2. Lawson, T.L., Foley, W.D., Berland, L.L. Ultrasonic evaluation of fetal kidneys: analysis of normal size and frequency of visualization as related to stage of pregnancy. Radiology. 2012
  3. Gruennewald, S.M., Craker, E.F., Walker, A.G. et al, Antenatal diagnosis of urinary tract abnormalities: correlation of ultrasound appearance with postnatal diagnosis. Am J Obstet Gynecol. 2016
  4. Stuck, K.J., Koff, S.A., Silver, T.M. Ultrasonic features of multicystic dysplasic kidney: expanded diagnosis criteria. Radiology. 2014
  5. Stephen, A., Kramer, M.D. Impact of fetal ultrasound. in: L.R. King (Ed.) Urologic surgery in neonates and young infants. Saunders, Philadelphia; 2012
  6. Avni, E.F., Thoua, T., Lalamed, B. et al, Multicystic dysplasic kidney natural history from in utero diagnosis and postnatal follow-up. J Urol. 2015
  7. Johnston, J.H. Renal cystic disease. in: P.P. Rickham, J. Lister, I.M. Irving (Eds.) Neonatal surgery. 2nd ed. Butterworths, London; 2013
  8. Howard, M., Snyder III. Cystic disease of the kidney, dysplasia and agenesis. in: K.J. Welch, J.G. Randolph, M.M. Ravitch, J.A. O’Neill Jr., M.I. Rowe (Eds.) Pediatric surgery. 4th ed. Year Book Medical Publishers Inc. 2016