Bilateral Renal Agenesis???

Question

Bilateral renal agenesis is a lethal condition, usually in the neonatal period due to pulmonary hypoplasia.

Question

Can these infants not be placed on ECMO (extracorporal membrane oxygenation) providing time for the lung to develope and hemodialysis??

Answer 1

Theoretically, yes. However, we live in the real world, and the success rate may be pretty low.

Answer 2

It would be nice if it would work, but it wouldn't.  ECMO is not a long-term solution under any circumstances, but the bigger part of the problem is that the lung development that should have been taking place during the pregnancy will never really happen--there is nothing there to develop, even if that could happen after birth.    The lungs are permanently damaged at that point--the alveolar sacs just don't develop.  

Infants with bilateral renal agenesis usually have a number of other malformations as well that are related to the lack of amniotic fluid (which is basically fetal urine, which obviously isn't present because it's produced by the kidneys) that can also be very serious in and of themselves.

Unfortunately, it is a lethal condition.  There is only so much we can correct, and no lungs and no kidneys in a neonate is beyond our abilities.  Even if there were no other abnormalities--and there usually are--the infant would need both a lung and kidney transplant within days of life.  An already impaired infant would never survive that kind of surgery.