Unilateral Renal Agenesis: Prenatal Diagnosis and Postnatal Issues

Unilateral renal agenesis (URA) is a urinary tract congenital anomaly characterized by a congenital absence or early developmental arrest of only one kidney. In the presence of a normal contralateral kidney, URA is typically considered a condition of minimal clinical significance as the solitary kid...

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Main Authors: Waldo Sepulveda, Amy E. Wong, Gabriele Tonni, Gianpaolo Grisolia, Angela C. Ranzini
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/13/1572
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author Waldo Sepulveda
Amy E. Wong
Gabriele Tonni
Gianpaolo Grisolia
Angela C. Ranzini
author_facet Waldo Sepulveda
Amy E. Wong
Gabriele Tonni
Gianpaolo Grisolia
Angela C. Ranzini
author_sort Waldo Sepulveda
collection DOAJ
description Unilateral renal agenesis (URA) is a urinary tract congenital anomaly characterized by a congenital absence or early developmental arrest of only one kidney. In the presence of a normal contralateral kidney, URA is typically considered a condition of minimal clinical significance as the solitary kidney often undergoes hypertrophy and can sufficiently perform the needed renal function after birth. However, postnatal studies suggest that URA has a significant association with other urinary and extra-urinary anomalies and may have implications for long-term health. This descriptive review focuses on the perinatal aspects of URA, emphasizing the main ultrasound findings to establish the prenatal diagnosis and to guide perinatal management. The pediatric implications of this diagnosis, particularly the high prevalence of long-term complications including hypertension, proteinuria, and a decreased glomerular filtration rate, are also briefly reviewed. URA is consistently associated with other ipsilateral urogenital anomalies. In females, there is a significant association with uterine anomalies that has significant implications for subsequent reproductive function. In males, the prevalence of both urinary and genital anomalies is also increased, which may also have implications for future fertility. Prenatal ultrasound offers the possibility of early diagnosis and parental counseling, which may result in timely intervention to reduce contralateral renal damage, prevent severe urogenital manifestations and co-morbidities, and improve fertility and the quality of life.
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spelling doaj-art-ca867fb2f4da43d38e8500fcf50477e02025-08-20T03:28:28ZengMDPI AGDiagnostics2075-44182025-06-011513157210.3390/diagnostics15131572Unilateral Renal Agenesis: Prenatal Diagnosis and Postnatal IssuesWaldo Sepulveda0Amy E. Wong1Gabriele Tonni2Gianpaolo Grisolia3Angela C. Ranzini4Fetal Imaging Unit, FETALMED—Maternal-Fetal Diagnostic Center, Santiago 7591047, ChileDepartment of Maternal-Fetal Medicine, Palo Alto Foundation Medical Group, Mountain View, CA 94301, USADepartment of Obstetrics and Gynecology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), AUSL Reggio Emilia, 42122 Reggio Emilia, ItalyDepartment of Obstetrics and Gynecology, Carlo Poma Hospital, ASST Mantova, 46100 Mantua, ItalyDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The MetroHealth System/Case Western Reserve University, Cleveland, OH 44109, USAUnilateral renal agenesis (URA) is a urinary tract congenital anomaly characterized by a congenital absence or early developmental arrest of only one kidney. In the presence of a normal contralateral kidney, URA is typically considered a condition of minimal clinical significance as the solitary kidney often undergoes hypertrophy and can sufficiently perform the needed renal function after birth. However, postnatal studies suggest that URA has a significant association with other urinary and extra-urinary anomalies and may have implications for long-term health. This descriptive review focuses on the perinatal aspects of URA, emphasizing the main ultrasound findings to establish the prenatal diagnosis and to guide perinatal management. The pediatric implications of this diagnosis, particularly the high prevalence of long-term complications including hypertension, proteinuria, and a decreased glomerular filtration rate, are also briefly reviewed. URA is consistently associated with other ipsilateral urogenital anomalies. In females, there is a significant association with uterine anomalies that has significant implications for subsequent reproductive function. In males, the prevalence of both urinary and genital anomalies is also increased, which may also have implications for future fertility. Prenatal ultrasound offers the possibility of early diagnosis and parental counseling, which may result in timely intervention to reduce contralateral renal damage, prevent severe urogenital manifestations and co-morbidities, and improve fertility and the quality of life.https://www.mdpi.com/2075-4418/15/13/1572empty renal fossafetal ultrasoundkidneyprenatal diagnosisrenal agenesissolitary kidney
spellingShingle Waldo Sepulveda
Amy E. Wong
Gabriele Tonni
Gianpaolo Grisolia
Angela C. Ranzini
Unilateral Renal Agenesis: Prenatal Diagnosis and Postnatal Issues
Diagnostics
empty renal fossa
fetal ultrasound
kidney
prenatal diagnosis
renal agenesis
solitary kidney
title Unilateral Renal Agenesis: Prenatal Diagnosis and Postnatal Issues
title_full Unilateral Renal Agenesis: Prenatal Diagnosis and Postnatal Issues
title_fullStr Unilateral Renal Agenesis: Prenatal Diagnosis and Postnatal Issues
title_full_unstemmed Unilateral Renal Agenesis: Prenatal Diagnosis and Postnatal Issues
title_short Unilateral Renal Agenesis: Prenatal Diagnosis and Postnatal Issues
title_sort unilateral renal agenesis prenatal diagnosis and postnatal issues
topic empty renal fossa
fetal ultrasound
kidney
prenatal diagnosis
renal agenesis
solitary kidney
url https://www.mdpi.com/2075-4418/15/13/1572
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