Bilateral Renal Agenesis: Redefining Complex Palliative Care Across the Continuum of a Shifting Disease Paradigm

Introduction: Bilateral renal agenesis was historically labeled “lethal” as pulmonary hypoplasia from chronic anhydramnios results in life-limiting respiratory failure at birth. Recently, the first case of long-term survival for an infant with bilateral renal agenesis to kidney transplant following serial prenatal amnioinfusion was reported. Subsequently, clinical trials have proposed prenatal amnioinfusions to allow for fetal pulmonary maturation, thus increasing the likelihood of survival at birth allowing for peritoneal dialysis as a bridge to kidney transplant. We report the role of palliative care across the continuum of multidisciplinary, complex care …