Renal agenesis physical examination
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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
Physical Examination
Unilateral renal agenesis (URA) have an increased incidence of proteinuria, hypertension, and renal insufficiency. Therefore, patients, even those with normal solitary kidney, should be followed up with:[1][2]
- Blood pressure
- Check for hypertension
- Urinalysis
URA may be isolated or associated with other anomalies and malformations. Therefore, screening and checking for other contralateral congenital anomaly of kidney or urinary tract (CAKUT), extra-renal anomalies, and associates syndromes and sequences (such as VACTERL, CHARGE and Trisomy 18) should be considered when URA is diagnosed. Some of the findings that may be important to consider in the physical exam of URA include:[3][4]
- Urinary tract
- Associated CAKUT
- VUR (vesicoureteral reflux)
- PUJO (pelviureteric junction obstruction)
- PUV (posterior urethral valves)
- Duplex kidney
- Ureterocele
- Megaureter
- Associated CAKUT
- Associated extra-renal anomalies
- Skull
- Dysraphism parieto-occipital
- Macrocephaly
- Anencephaly
- Skull
- Spine
- Spina bifida
- Hemivertebra
- Coccygeal congenital fistula
- Skeleton
- Face
- Thorax
- Diaphragmatic hernia
- Thoracic haemangioma
- Heart
- Lung
- Congenital lung cyst
- Agenesis of lung
- Genital system
- Female tract anomalies
- Unicornate uterus
- Developmental ovarian cyst
- Female tract anomalies
References
- ↑ 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.
- ↑ 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.
- ↑ Laurichesse Delmas H, Kohler M, Doray B, Lémery D, Francannet C, Quistrebert J; et al. (2017). "Congenital unilateral renal agenesis: Prevalence, prenatal diagnosis, associated anomalies. Data from two birth-defect registries". Birth Defects Res. 109 (15): 1204–1211. doi:10.1002/bdr2.1065. PMID 28722320.
- ↑ Westland R, Schreuder MF, Ket JC, van Wijk JA (2013). "Unilateral renal agenesis: a systematic review on associated anomalies and renal injury". Nephrol Dial Transplant. 28 (7): 1844–55. doi:10.1093/ndt/gft012. PMID 23449343.