One Kidney Syndrome

At the start of every semester, in every tutorial, in every subject, you say your name, what you study and an interesting fact about yourself. Everyone always seems to struggle on this last question – but not me.

This is easy.
I was born for this question.
I have one kidney.
One the size of two in fact.

To me, this isn’t something weird or unusual. Just something I have always had. It has never stopped me from participating in any sports, nor has it ever presented a problem.  It was only discussing my interesting fact in my latest tutorial that it dawned on me that I should learn about my condition.  I wasn’t even sure what it was called – one kidney syndrome?- , how it came about, and if there was anything dire I was in for.

The condition is called uni renal agenesis, if one remains. In these cases, during the 22nd week of gestation the cells of the remaining kidney divide at a higher rate than usual, allowing for compensatory growth. This allows the single kidney to perform the heavy lifting of two, without resulting in any stress or damage. The condition occurs in 1 in 750 adults, and is twice as common in males than females. A large proportion of those with uni renal agenesis aren’t even aware of how unique they are, until there is a problem. You could be walking around with a single mega kidney and not even realize. Fortunately for myself and others with uni renal agenesis, research suggests that the main side effect seems to be hypertension – especially for women during pregnancy.

agenesisrecon

3D coronal reconstruction of CT scan of Uni Renal Agenesis. Credit: www.med-ed.virginia.edu

But when both kidneys fail to develop – Bi-renal agenesis – the child is either a stillborn or does not survive past the first few hours. Without any kidneys, a human is unable to produce urine which, while seemingly a pretty mundane task, actually removes a high proportion of waste that your blood produces. Without kidneys, or kidney, your waste builds up in your system and subsequently will poison you. On top of this, kidneys keep a balance of crucial chemicals in your blood, they help red blood cell growth and produce the hormones that control blood pressure.

If, by some miracle, the child does survive through those first few hours, there are a number of abnormalities that characteristically occur with bi-renal agenesis including:

  • Absent bladder.

  • Underdeveloped lungs

  • Absent sex organ structures, such as the vas deferens and seminal vesicles in males, and the uterus in females.

  • Absent rectum and anus

  • Gap in the oesophagus

  • Malformations of the legs.

But what predisposes one to developing these conditions? Both uni and bi renal agenesis are linked to a number of prenatal factors including diabetes, younger maternal age, and consumption of alcohol during pregnancy as well as a number of drugs including thalidomide, arsenates and cocaine.

But, as with a number of birth defects, sometimes there are no reason – my mother had done none of the above – and was seemingly quite shocked when I asked her if she had done cocaine during her pregnancy.

So what am I in for in my future life?
Not much it looks like.
If I keep a healthy lifestyle, avoid activities that could possibly cause damage – there goes my dream of rodeo – and watch my blood pressure, especially during pregnancy, cross fingers, everything should continue to function as normal.


5 Responses to “One Kidney Syndrome”

  1. jfrench says:

    Hi Sarah,

    Thanks for sharing your mega-kidney story!

    I like jbreadsell, had not heard about uni renal agenesis before your post. 1 in every 750 people, that’s actually pretty common!

    we do under estimate our lil kidneys role so it was great you highlighted their importance.

  2. griffith says:

    Thanks!
    I found out because as a child it was actually discovered in me due to recurring UTI’s when I was very very young – a common sign in young females who have the condition – although it was only due to my parents and doctor pushing to find out why they were recurring did we even discover it. Most people assume its just a young child problem and keep prescribing medication to fix until they grow out of it. In boys this isn’t often a present symptom, meaning many of them go unaware until there is a serious problem – if one ever appears!

    There is actually very little research in to uniR-A and why it occurs – and even for biR-A as many of the children die very very early on, or receive a donor kidney meaning that the research is focused on that transplant rather than what cause the biR-A.

    Hopefully now I have actually looked into the condition I will be more aware about research into uni R-A, especially in terms of health as I get older!

  3. griffith says:

    As a child it was actually discovered in me due to recurring UTI’s when I was very very young – a common sign in young females who have the condition – although it was only due to my parents and doctor pushing to find out why they were recurring did we even discover it. Most people assume its just a young child problem and keep prescribing medication. In men this isn’t often a present symptom, meaning many of them go unaware until there is a serious problem – if one every appears!

  4. jbreadsell says:

    This is a fascinating condition which I had never heard of before, thankyou for the post. If you don’t mind me asking, how is it diagnosed in the first place? If there are minimal side effects until things go wrong, could there be more people out there who don’t know they have it?

  5. egiles says:

    Really interesting post! I think it’s great that you chose to write about something personal. Thanks so much for sharing 🙂

    I was wondering how you found out that you only have one kidney, as you mentioned you haven’t had any complications and that many wouldn’t even know they had it!
    Considering prenatal factors clearly aren’t the only contributing factor to uni renal agenesis, have you come across any other causes in your research?