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Renal agenesis ureteric bud — MRCPCH TAS MCQ

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HardEmbryologyRenal agenesis ureteric budMRCPCH TAS

A fetus has severe oligohydramnios, absent bladder filling and absent kidneys on ultrasound. Postnatal examination shows pulmonary hypoplasia and limb positioning deformities. What is the most likely developmental abnormality?

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Correct answer: A — Failure of ureteric bud interaction with metanephric mesenchyme

Bilateral renal agenesis results from failed ureteric bud interaction with metanephric mesenchyme, preventing kidney development and fetal urine production. Enteric neural crest failure causes Hirschsprung disease rather than absent kidneys. The pearl is that the Potter sequence reflects oligohydramnios secondary to absent fetal urine.

Reference: Gray's Anatomy; Nelson Textbook of Pediatrics; RCPCH Theory examination syllabi