Being “anephric” describes a state where an individual possesses no functional kidneys. This means the body loses its natural ability to filter waste products from the blood and regulate fluid and electrolyte balance. Without these processes, harmful substances accumulate, disrupting the body’s internal environment and necessitating external intervention.
Why Someone Becomes Anephric
An individual can become anephric through several distinct pathways. One rare cause is congenital absence, known as bilateral renal agenesis, where a person is born without either kidney. This condition is often detected prenatally and is incompatible with life without immediate medical intervention.
More commonly, an anephric state results from surgical removal of both kidneys, a procedure called bilateral nephrectomy. This surgery is performed to address severe kidney diseases, such as aggressive kidney cancers affecting both organs, or in cases of polycystic kidney disease where cysts become large or infected. Patients undergoing kidney transplantation may also have their native kidneys removed if they are a source of infection or uncontrolled hypertension.
Patients with end-stage kidney disease (ESKD) can also be considered functionally anephric, even if their kidneys are physically present. In ESKD, the kidneys have sustained irreversible damage and can no longer perform their filtering and regulatory duties effectively, requiring external support to sustain life.
How Life is Maintained Without Kidneys
Life cannot be sustained for an extended period without functioning kidneys, making medical intervention absolutely necessary. The primary methods for managing an anephric state involve either mechanical filtration of the blood or receiving a new organ. Both remove metabolic waste products and maintain fluid and electrolyte balance.
Dialysis is a life-sustaining treatment. Hemodialysis involves circulating the patient’s blood through an external machine with a dialyzer to remove waste and excess fluids. This process typically occurs at a clinic several times a week, with each session lasting a few hours.
Peritoneal dialysis offers an alternative, using the lining of the abdomen, the peritoneum, as a natural filter. A sterile solution is introduced into the abdominal cavity through a catheter, where it dwells for several hours, absorbing waste and excess fluid. The solution is then drained and replaced, performed daily at home, providing flexibility for patients.
Kidney transplantation represents the preferred long-term solution. This surgical procedure involves implanting a healthy kidney from a deceased or living donor into the recipient. A successful transplant restores kidney function, allowing the recipient to live without dialysis. Following transplantation, patients must take immunosuppressant medications indefinitely to prevent their immune system from rejecting the new organ.