No Kidneys?

I often wonder how many parents thought the same as I did when I found out my baby had no kidneys, did they also think their baby could have a kidney transplant once they were born and everything would be ok?

The advances in modern medicine have shown that people can live long lives with one kidney and that dialysis can support life so why would none of these be an option for my baby or any baby born without kidneys?

Little did I know how vitally important the kidneys and amniotic fluid were during those 9 months of pregnancy.

The Urinary System

The urinary system (which consists of the kidneys, ureters, bladder, and urethra) is a system of the body for removing waste products and it controls water volume as well as maintaining a balance of essential salts and minerals our bodies need to function.

The kidneys are 2 bean-shaped organs that can be found on either side of the body, and their primary function is to make urine, but the kidneys are also involved in many important functions within the body including:

• Producing urine, maintaining water volume, salt and mineral balance.
• The removal of waste products such as medication, uric acid and compounds produced from cells in our body which we have no use for.
• Produce and release into the body a hormone which encourages red blood cells to be made.
• Produce and release a substance (enzyme) which is important in the long-term control of our blood pressure.

And sitting on top of the kidneys are little glands called Adrenal Glands which are important in our ‘Flight or Fight’ responses. They make important hormones that the body needs to help with metabolism, and immune responses, and help us deal with stress.

All these processes are essential for life.

But what is the role of the kidneys during pregnancy?

In early pregnancy, amniotic fluid is made by the mother to protect and support a developing baby. Around 14-16 weeks but can be as early as 11 weeks of pregnancy, the baby will start to ‘breathe’ and swallow amniotic fluid. The amniotic fluid surrounds and fills a developing baby during pregnancy, it is full of nutrients, water and infection-fighting cells.

But it also develops vital body systems such as the urinary system and the lungs which are part of the respiratory system.

Helping to grow and develop a baby’s lungs will enable them to breathe on their own when they are born.

But if there are no kidneys, amniotic fluid levels drop until they are very low or there is no fluid around the baby at all. And this means that the body systems that rely on amniotic fluid to grow, stop growing.

In the lungs this sadly results in a condition called Pulmonary Hypoplasia.

Pulmonary Hypoplasia

What this means is that a baby who has low amniotic fluid will most likely have very small, underdeveloped lungs. Very small lungs will not be able to breathe on their own due to their reduced size and reduced number of minute structures that help to get oxygen into the body.

In the UK low amniotic fluid is usually detected at a 20wk anomaly scan, and then parents are referred to a fetal medicine consultant for diagnosis.

Bilateral Renal Agenesis is a condition where both kidneys fail to develop during the early stages of pregnancy.

It is a rare condition with no known cause as to why it happens but there may be a genetic link if there is a history of Unilateral Renal Agenesis (one kidney missing) or Bilateral Renal Agenesis within a family.

Finding out that there was going to be no intervention, no kidney transplant, no dialysis for my baby was a huge shock. On one hand, I knew what they were telling us was very serious and our baby was very sick but on the other, I was heavy-hearted and broken at the only 2 choices we had resulted in our baby dying.

Ultimately, we said goodbye to our baby at nearly 22 weeks of pregnancy and there has not been a day that has gone by since they died that we don’t think about them or say their name and wish things could have been oh so very different if their kidneys had just developed.

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