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Renal Agenesis and Noncystic Renal DysplasiaFrom: Rich Dempsey RDMS/RVT (ridem@msn.com)Fri May 18 21:18:06 2001
Scanned a 7 day old female infant,(born at 38 weeks prematurity) with a creatinine of 3.0, and metabolic acidosis (although the infant apparently has a malrotated gut and vomiting), and abmormal blood K levels. Lasix injection resulted in 70 cc of urine. They infant has lost 20% of its birthweight, presumably due to dehydration. I was unable to locate a right kidney, after an extensive search from the right adrenal gland down the psoas to the pelvis. The LEFT kidney was in the expected location, but measured only 2.5 cm, which is 2 SD below the mean of 4.5 cm for a newborn. Scanning (last resort) through the infant's back the left kidney, psoas, spine, and right psoas were vizualized. I felt that fused cross ectopia, etc was unlikely, although a nuclear renogram is the next planned test. There was no hydronephrosis, cortical or medullary cysts. The solitary kidney appeared mildly echogenic; there were hypoechoic areas within the renal cortex/medulla, however they were NOT arranged like neonatal renal pryramids. I don't believe that they were cysts though. MOST unfortunately I was unable to do Color Doppler for renal vein thrombosis,presence of a RRenArt, etc. There was a small amount of urine present in the normal appearing bladder, a uterus and (probably? both ovaries were briefly seen). This was a tough scan,done portably, on an irritable neonate. Anyone know of syndromes with these findings, or are the findings just part of the continuum stopping short of bilateral renal agenesis ? (Solitary dysplastic kidney). Reply: ridem@msn.com
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