Difference between revisions of "Renal agenesis medical therapy"

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{{CMG}} {{AE}} {{SHA}}
 
{{CMG}} {{AE}} {{SHA}}
 
== Overview ==
 
== Overview ==
Patients with unilateral renal agenesis (URA may progress to [[Renal insufficiency|renal insufficienc]]<nowiki/>y that may progress to [[End stage renal disease|end stage renal disease (ESRD)]] and therefore may require medical treatment  or [[renal replacement therapy]]. The [[mortality rate]] of bilateral renal agenesis (BRA) without prenatal therapy with serial amnioinfusion, however is 100%, however, further studies are required to assess the outcome, risks and benefits of serial amnioinfusion, infancy [[dialysis]]  and  [[kidney transplantation]].
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Patients with unilateral renal agenesis (URA may progress to [[renal insufficiency]]<nowiki/>y that may progress to [[End stage renal disease|end stage renal disease (ESRD)]] and therefore may require medical treatment  or [[renal replacement therapy]]. Early [[diagnosis]] of unilateral renal agenesis <u>(</u>URA<u>)</u> and immediate intervention is helpful in controlling the progression to [[renal insufficiency]]. The [[mortality rate]] of bilateral renal agenesis (BRA) without prenatal therapy with serial amnioinfusion, however is 100%, however, further studies are required to assess the outcome, risks and benefits of serial amnioinfusion, infancy [[dialysis]]  and  [[kidney transplantation]].
 +
 
  
 
== Medical Therapy ==
 
== Medical Therapy ==
Patients with unilateral renal agenesis (URA) have an increased risk for [[proteinuria]], [[hypertension]], and [[Renal insufficiency|renal insufficienc]]<nowiki/>y that may progress to [[End stage renal disease|end stage renal disease (ESRD)]] and may require medical treatment (for example with [[ACE inhibitor|ACE inhibitors]]) or [[renal replacement therapy]] (such as [[dialysis]]).<ref name="pmid30734167">{{cite journal| author=Xu Q, Wu H, Zhou L, Xie J, Zhang W, Yu H | display-authors=etal| title=The clinical characteristics of Chinese patients with unilateral renal agenesis. | journal=Clin Exp Nephrol | year= 2019 | volume= 23 | issue= 6 | pages= 792-798 | pmid=30734167 | doi=10.1007/s10157-019-01704-x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30734167  }} </ref><ref name="pmid16956352">{{cite journal| author=Woolf AS, Hillman KA| title=Unilateral renal agenesis and the congenital solitary functioning kidney: developmental, genetic and clinical perspectives. | journal=BJU Int | year= 2007 | volume= 99 | issue= 1 | pages= 17-21 | pmid=16956352 | doi=10.1111/j.1464-410X.2006.06504.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16956352  }} </ref><ref name="pmid1457321">{{cite journal| author=Argueso LR, Ritchey ML, Boyle ET, Milliner DS, Bergstralh EJ, Kramer SA| title=Prognosis of patients with unilateral renal agenesis. | journal=Pediatr Nephrol | year= 1992 | volume= 6 | issue= 5 | pages= 412-6 | pmid=1457321 | doi=10.1007/BF00873996 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1457321  }} </ref>
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Patients with unilateral renal agenesis (URA) have an increased risk for [[proteinuria]], [[hypertension]], and [[Renal insufficiency|renal insufficienc]]<nowiki/>y that may progress to [[End stage renal disease|end stage renal disease (ESRD)]] and may require medical treatment (for example with [[ACE inhibitor|ACE inhibitors]]) or [[renal replacement therapy]] (such as [[dialysis]]).<ref name="pmid30734167">{{cite journal| author=Xu Q, Wu H, Zhou L, Xie J, Zhang W, Yu H | display-authors=etal| title=The clinical characteristics of Chinese patients with unilateral renal agenesis. | journal=Clin Exp Nephrol | year= 2019 | volume= 23 | issue= 6 | pages= 792-798 | pmid=30734167 | doi=10.1007/s10157-019-01704-x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30734167  }} </ref><ref name="pmid16956352">{{cite journal| author=Woolf AS, Hillman KA| title=Unilateral renal agenesis and the congenital solitary functioning kidney: developmental, genetic and clinical perspectives. | journal=BJU Int | year= 2007 | volume= 99 | issue= 1 | pages= 17-21 | pmid=16956352 | doi=10.1111/j.1464-410X.2006.06504.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16956352  }} </ref><ref name="pmid1457321">{{cite journal| author=Argueso LR, Ritchey ML, Boyle ET, Milliner DS, Bergstralh EJ, Kramer SA| title=Prognosis of patients with unilateral renal agenesis. | journal=Pediatr Nephrol | year= 1992 | volume= 6 | issue= 5 | pages= 412-6 | pmid=1457321 | doi=10.1007/BF00873996 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1457321  }} </ref> Early [[diagnosis]] of unilateral renal agenesis <u>(</u>URA<u>)</u> and immediate intervention is helpful in controlling the progression to [[renal insufficiency]].<ref name="pmid30734167" />
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The [[mortality rate]] of bilateral renal agenesis (BRA) without prenatal therapy with serial amnioinfusion, however is 100%, however, further studies are required to assess the outcome, risks and benefits of this treatment. In addition, further studies are required to assess the outcome of [[Renal replacement therapy|renal replacement]] with [[dialysis]] in infancy and also [[kidney transplantation]].<ref name="pmid31098643">{{cite journal| author=Huber C, Shazly SA, Blumenfeld YJ, Jelin E, Ruano R| title=Update on the Prenatal Diagnosis and Outcomes of Fetal Bilateral Renal Agenesis. | journal=Obstet Gynecol Surv | year= 2019 | volume= 74 | issue= 5 | pages= 298-302 | pmid=31098643 | doi=10.1097/OGX.0000000000000670 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31098643  }} </ref>
 
The [[mortality rate]] of bilateral renal agenesis (BRA) without prenatal therapy with serial amnioinfusion, however is 100%, however, further studies are required to assess the outcome, risks and benefits of this treatment. In addition, further studies are required to assess the outcome of [[Renal replacement therapy|renal replacement]] with [[dialysis]] in infancy and also [[kidney transplantation]].<ref name="pmid31098643">{{cite journal| author=Huber C, Shazly SA, Blumenfeld YJ, Jelin E, Ruano R| title=Update on the Prenatal Diagnosis and Outcomes of Fetal Bilateral Renal Agenesis. | journal=Obstet Gynecol Surv | year= 2019 | volume= 74 | issue= 5 | pages= 298-302 | pmid=31098643 | doi=10.1097/OGX.0000000000000670 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31098643  }} </ref>

Revision as of 13:17, 2 August 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]

Overview

Patients with unilateral renal agenesis (URA may progress to renal insufficiencyy that may progress to end stage renal disease (ESRD) and therefore may require medical treatment or renal replacement therapy. Early diagnosis of unilateral renal agenesis (URA) and immediate intervention is helpful in controlling the progression to renal insufficiency. The mortality rate of bilateral renal agenesis (BRA) without prenatal therapy with serial amnioinfusion, however is 100%, however, further studies are required to assess the outcome, risks and benefits of serial amnioinfusion, infancy dialysis and kidney transplantation.


Medical Therapy

Patients with unilateral renal agenesis (URA) have an increased risk for proteinuria, hypertension, and renal insufficiency that may progress to end stage renal disease (ESRD) and may require medical treatment (for example with ACE inhibitors) or renal replacement therapy (such as dialysis).[1][2][3] Early diagnosis of unilateral renal agenesis (URA) and immediate intervention is helpful in controlling the progression to renal insufficiency.[1]


The mortality rate of bilateral renal agenesis (BRA) without prenatal therapy with serial amnioinfusion, however is 100%, however, further studies are required to assess the outcome, risks and benefits of this treatment. In addition, further studies are required to assess the outcome of renal replacement with dialysis in infancy and also kidney transplantation.[4]

References

  1. 1.0 1.1 Xu Q, Wu H, Zhou L, Xie J, Zhang W, Yu H; et al. (2019). "The clinical characteristics of Chinese patients with unilateral renal agenesis". Clin Exp Nephrol. 23 (6): 792–798. doi:10.1007/s10157-019-01704-x. PMID 30734167.
  2. Woolf AS, Hillman KA (2007). "Unilateral renal agenesis and the congenital solitary functioning kidney: developmental, genetic and clinical perspectives". BJU Int. 99 (1): 17–21. doi:10.1111/j.1464-410X.2006.06504.x. PMID 16956352.
  3. Argueso LR, Ritchey ML, Boyle ET, Milliner DS, Bergstralh EJ, Kramer SA (1992). "Prognosis of patients with unilateral renal agenesis". Pediatr Nephrol. 6 (5): 412–6. doi:10.1007/BF00873996. PMID 1457321.
  4. Huber C, Shazly SA, Blumenfeld YJ, Jelin E, Ruano R (2019). "Update on the Prenatal Diagnosis and Outcomes of Fetal Bilateral Renal Agenesis". Obstet Gynecol Surv. 74 (5): 298–302. doi:10.1097/OGX.0000000000000670. PMID 31098643.