Agenesis of Kidney

  • Etiology:
    — Failure of induction of the nephrogenic blastema by ureteric bud leads to absent kidney
  • Imaging:
    — Absent kidney with contralateral prominent adrenal gland
    — Smaller bladder due to not being used as much
    — Unilateral renal agenesis associated with Mullerian abnormalities
  • DDX: Multicystic dysplastic kidney which has a normal shape to its adrenal gland while renal agenesis will have a pancake shape to its adrenal gland which will be a flat adrenal gland without visualization of the adrenal limbs
  • Complications: If bilateral leads to oligohydramnios which leads to pulmonary hypoplasia and Potter syndrome
  • Treatment:
  • Clinical:
    — Contralateral renal abnormality in 31-48%
    — Can be unilateral or bilateral
    — If bilateral is fatal

Radiology Cases of Agenesis of Kidney

IVP of renal agenesis
AP image from the nephrogram phase of a vintage intravenous pyelogram shows a dense nephrogram in the right renal fossa representing the right kidney with contrast draining down the right ureter and filling the bladder. There is no nephrogram noted in the left renal fossa.

Radiology Cases of Agenesis of Kidney in VACTERL Association

Radiograph of VACTERL association with vertebral body anomalies
AP radiograph of the spine (left) shows multiple segmentation anomalies in the sacrum. Sagittal US of the left kidney (above right) is unremarkable while sagittal US of the right renal fossa (below right) shows a prominent right adrenal gland and absence of the right kidney.

Radiology Cases of Zinner Syndrome (Agenesis of Kidney and Ipsilateral Seminal Vesicle Cyst)

US of kidney agenesis and seminal vesicle cyst / Zinner syndrome
Sagittal US of the left renal fossa (above) demonstrated that no left kidney was present in the left renal fossa or pelvis. Transverse ultrasound of the bladder (below) demonstrated a cystic structure adjacent to the left side of the bladder.