ExtractThirty-one newborns with anencephaly had small kidneys; the weights of these organs were only 67 % of the mean value for control infants of the same gestational age. Kidneys of the anencephalic infants had only 81 % as many nephrons as kidneys of the control infants. In the kidneys of anencephalic newborns, tubular cells distal to the proximal convoluted tubules contained less cytoplasm than did comparable cells of control subjects. For example, in anencephalic infants, cells in the distal convoluted tubules had only 57% as much cytoplasm as control cells. Pituitary dysfunction may be directly or indirectly responsible for this maldevelopment, since in this study, an infant with isolated congenital absence of the pituitary had similar renal abnormalities while a newborn anencephalic infant with a normal parabiotic twin partner had near normal kidneys.
SpeculationDysfunction of the hypothalmic-neurohypophyseal system might contribute to the hydramnios common in anencephalic gestations by leading to increased urine output by the fetus. In any case, nephron structure is so abnormal in anencephalic newborns that it should be interesting to test their renal function.Introduction was undertaken to search for possible renal abnormalities associated with presumed prenatal hypothalamicThe pituitary gland is usually present in anencephalic neurohypophyseal dysfunction in anencephaly. Quanneonates but it is almost always abnormal. Anterior titative morphologic methods were used and results lobe acidophils are reported to be subnormal innumber suggest that specific renal abnormalities may be directand there are fine structural evidences of subnormal ly or indirectly related to prenatal pituitary dyssecretory activity [2,5,6]. End organ manifestations function, of this anterior lobe dysfunction are found in the adrenals and the epididymus [2,16]. Although several investigators have reported that the posterior lobe of the Case Material pituitary is structurally and functionally abnormal in such infants, no studies of their renal structure or func-Autopsy material was examined from 69 anencephalic tion have been published [2,3,11]. The present study infants who were stillborn or died in the immediate 258 NAEYE, BLANC, MILIC