Monday, May 2, 2016

First Child Born Without Kidneys

The first child ever to survive a condition called bilateral renal agenesis (the failure of kidneys to develop in the fetus) will be three years old this July. Young Abigail Beutler is the daughter of Congresswoman Jaime Herrera-Beutler from Washington state and her husband, Dan.

Bilateral renal agenesis occurs in about 1 in 5,000 pregnancies. In the past, such fetuses always died before birth. That's because the urine produced by the fetus's kidneys is the source of most of the amniotic fluid that bathes a fetus; without adequate amniotic fluid, the fetus's lungs fail to develop normally. Representative Herrera-Beutler's fetus (the future Abigail) was kept alive during gestation by an experimental procedure in which Rep. Herrera-Beutler received intra-abdominal injections of saline throughout late pregnancy, simulating amniotic fluid. The technique worked, and Abigail was born successfully on July 15, 2013.

But that was only the beginning of young Abigail's survival story. Because she was born without kidneys, she was on dialysis from birth until she was old enough for a kidney transplant. Fortunately, both of her parents were good matches for the transplant. On Feb. 8 of this year when she was 2 1/2 years old, Abigail received one of her father's kidneys. Both father and daughter are doing well.

Call it yet another lifesaving advance in medicine. We can probably expect the saline injection technique used in this case to become the standard treatment for fetuses diagnosed with bilateral renal agenesis.

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