Unilateral kidney deficiency

　　Etiology:The embryonic development of URA is not significantly different from that of BRA, and the main problem is still with the ureteral bud. During the embryonic period, the growth of one renal tissue and ureteral bud is disordered and fails to develop, and the contralateral kidney often presents with compensatory hypertrophy. The undeveloped kidney has no renal parenchyma, renal pelvis, and renal pedicle remnants, and the ureter is fibrous cord-like tissue without lumen.

　　This disease often occurs with other urogenital system abnormalities, such as atypical vessels, ectopic kidney, malrotation of kidney, obstruction of renal pelvis and ureteral junction, hypospadias, cryptorchidism, bicornuate uterus, double ureters, contralateral adrenal gland, seminal vesicle, testis, fallopian tube, ovary deficiency, anal atresia, and spinal deformity, etc.

　　In addition, patients often have abnormalities in other organ systems, such as cardiovascular system (30%), digestive system (25%), musculoskeletal system (14%), etc. Therefore, once a patient is found to have more than one system of developmental abnormalities in addition to unilateral kidney deficiency, a comprehensive examination of all systems should be performed.

　　The etiology of this disease is unclear, and it is related to autosomal recessive inheritance. It is usually associated with marriage between close relatives, and there is no direct prevention for this disease. Patients with a suspected family history of chromosomal abnormalities should undergo genetic screening to avoid offspring suffering from this disease due to chromosomal inheritance. At the same time, attention should be paid to strengthening pregnancy nutrition, reasonable diet, and avoiding adverse stimuli that affect embryonic development, such as emotional excitement.

　　1. Cystoscopy:The bladder trigone area is asymmetric, one ureteral spine atrophy is flat, the ureteral orifice is absent, and some have orifices but are blocked by catheter insertion; on the other side, the ureteral orifice is usually in the normal position, but can also be ectopic in the midline, posterior urethra, or seminal vesicle.

　　2. Abdominal plain film + KUB:Intravenous urography (IVU) shows a missing renal shadow on one side, no shadowing, an enlarged contralateral renal shadow, and can find other malformations of solitary kidneys.

　　3. Ultrasound, CT, renal scans, renal arteriography, and other imaging methods can assist in diagnosis.

　　1. What foods are good for patients with unilateral renal agenesis:Eat light, easy-to-digest food, fresh vegetables, and a moderate amount of fruit, and drink water appropriately. Pay attention to a balanced diet and nutrition.

　　2. What foods should be avoided for unilateral renal agenesis:Avoid overeating and eating unclean food. Avoid seafood, beef, mutton, spicy and刺激性 food, alcohol, and all kinds of irritants such as five-spice powder, coffee, coriander, etc. Avoid all tonics, tonics, and easy-to-cause heat food such as chili, intelligence, chocolate, etc.

　　1, Treatment

　　Generally, no treatment is required. If complications such as hydronephrosis caused by poor rotation or other complications occur, they should be dealt with according to the specific situation. The general principle is to protect renal function as much as possible, and then decide on the treatment plan under this premise. The clinical significance of this condition lies in the diagnosis of other urinary system diseases, and before surgical treatment, the possibility of a solitary kidney should be considered. This is to avoid discovering that the contralateral kidney is absent after the removal of the affected kidney or severe damage to the renal function of the affected side due to surgery, resulting in a permanent regret.

　　2, Prognosis

　　There is no clear evidence to show that patients with a single kidney have a higher susceptibility to other diseases. However, some people believe that patients with a single kidney have a higher incidence of diseases such as pyelonephritis, kidney stones, ureteral stones, tuberculosis, glomerulonephritis, and so on. The current emphasis on preventing infection and its sequelae has greatly reduced the incidence and mortality of patients with a single kidney. 5% of patients die due to kidney injury, while such patients may survive if they have two kidneys. Therefore, it is recommended that patients with URA should be more cautious and careful in their activities. Rugui et al. reported that URA patients are prone to hypertension, hyperuricemia, and decreased renal function, but no proteinuria occurs. Arguero evaluated the incidence of hypertension and proteinuria in 157 middle-aged URA patients, which was 47% and 19% respectively, but the incidence of renal insufficiency was only 13%. Despite this, the lives of these patients are not significantly affected.