Fetal Renal Failure

The Stanford Medicine Children’s Health Fetal and Pregnancy Health Program provides multidisciplinary evaluation and management of fetal renal failure. Our program combines expertise from specialists in maternal-fetal medicine, pediatric radiology, nephrology, dialysis, neonatology, and pediatric surgery to provide well-rounded prenatal and postnatal management of fetal renal failure.

What is fetal renal failure?

Fetal renal failure is when your baby’s kidneys do not form correctly in the womb. The fetal renal conditions we treat include a group of rare and complex kidney birth malformations called congenital anomalies of the kidney and urinary tract (CAKUT). This includes kidneys that never develop (renal agenesis), kidneys that may not function as expected because they did not form normally (renal dysplasia), and lower urinary tract obstruction (LUTO)—a blockage in a fetus’s urinary tract.  

How do you diagnose fetal renal failure?

During your routine pregnancy care, your child’s CAKUT will most likely be diagnosed via ultrasound. When your doctor has a concern, you may be referred to our Fetal and Pregnancy Health Program for perinatal testing, prenatal counseling, and care management. Additional specialized prenatal imaging, such as fetal magnetic resonance imaging (MRI), may be recommended.

What does having fetal renal failure mean for my child?

In some cases of CAKUT, your child may need dialysis soon after birth to stay healthy, followed by an eventual kidney transplant. Stanford Children’s is known nationwide for our exceptional, lifelong kidney transplant care. We have outstanding success in providing extraordinary care for newborns and children of all ages before transplant, as well as achieving a high quality of life for your child afterward.

How does Packard Children’s Hospital care for fetal renal failure?

Treatment is individualized to the patient, and it is focused on many factors, including severity and onset of fetal renal failure. As part of our multidisciplinary team, pediatric nephrology and pediatric urology are centrally involved in prenatal counseling and care with neonatology and maternal-fetal medicine (high-risk pregnancy specialists). Depending on the condition, your child may be able to participate in an ongoing trial of innovative prenatal approaches, including the RAFT trial for mothers diagnosed with early pregnancy renal anhydramnios (EPRA). After delivery, your baby will receive care from our highly specialized NephroNICU program at Packard Children’s, which is one of just a handful of programs like it in the nation offering multispecialty kidney and neonatal care.