Newborn's Kidney Care Offers Parents Hope and a Solution

Even inside the womb, baby Lola Prieto seemed to know her parents needed signs she would thrive.

Their daughter’s health was something Sasha Cordero and Victor Prieto could never take for granted. At Sasha’s 20-week pregnancy sonogram in July 2022, the Butler, New Jersey, couple was given ominous news: The baby’s kidneys, which make urine by filtering waste products from blood, appeared to be covered with cysts that might prevent the organs from working—or even prove fatal.

“It looked like a bunch of grapes on both kidneys,” Sasha recalls. “The doctor told us the baby might not make it. But right then was the first time I actually felt the baby kick and move.”

Positive thinking and vigilant care with Hackensack Meridian Health maternal-fetal medicine specialists—which included weekly follow-up ultrasounds—helped carry Sasha and Victor through the remainder of the pregnancy. So did a “thumbs-up” from Lola during a sonogram, her tiny hand clearly in view on the screen.  

“It was almost like her telling us, ‘Everything’s going to be OK,’” Victor says. “We tried to take any little sign as positivity.”

Dramatic Delivery  

About a month before her due date, Sasha had just left a medical visit and was on her way to pick up dinner when her phone rang. Her doctor told her Lola’s belly was severely swollen with fluid from her malfunctioning kidneys and needed to be delivered right away. An emergency C-section in late October 2022 delivered a squalling Lola, but doctors immediately noticed she was having trouble breathing.

“She was in bad shape, because the extra fluid was impacting her lungs and abdomen,” says Richard Schlussel, M.D., co-director of pediatric urology at Hackensack Meridian Health. “It was almost like she swallowed a softball, and it was crowding out everything else.”

Dr. Schlussel collaborated with Kenneth Lieberman, M.D., chief of pediatric nephrology at Joseph M. Sanzari Children’s Hospital, to pinpoint what was wrong with Lola’s urinary system. Additional sonograms revealed she had a condition known as a ureteropelvic junction (UPJ) obstruction, which the doctors describe as a “plumbing issue” that occurs when a kidney is blocked where it attaches to the tube carrying urine to the bladder.

“Urine was trapped in the kidney, and it just ballooned,” Dr. Lieberman explains. “A congenital blockage of the urinary tract is rare overall, but it’s really unusual when it happens to this very extreme degree.”

As serious as the diagnosis was, however, it was still preferable to what doctors had originally feared during Sasha’s pregnancy. “A UPJ obstruction is definitely better than polycystic kidneys, which don’t function at all,” Dr. Schlussel says.

‘No Gaps in Care’

A month-long stay in the neonatal intensive care unit (NICU) stabilized Lola, who had a temporary catheter placed into her blocked kidney to drain urine as she grew and gained strength. At two months old, in January 2023, Dr. Schlussel performed an intricate surgery to repair Lola’s kidney obstruction, removing the blocked portion of her urinary tract and reconnecting the healthy portions.

Within days, Lola was sent home from the hospital with her jubilant parents, her recovery progressing without any complications. The little girl will need regular monitoring to ensure her urinary system continues to function normally as expected. “We’ll have to watch out for dehydration, urinary tract infections or maybe bed-wetting,” Sasha says. “But to us, that’s nothing.”

Now six months old, the hazel-eyed girl is constantly smiling and babbling, hitting all her developmental milestones and eating pureed food. “No one can believe this is the same baby,” says Sasha, a Hackensack Meridian Children’s Health team member in pediatric audiology.

The broad array of specialists and unparalleled teamwork at the Children’s Hospital made all the difference in Lola’s outcome, her parents and doctors agree.

“The advantage of a pediatric medical center like ours is that there are no gaps in care,” Dr. Schlussel says. “We attract people with expertise in very uncommon conditions. I’m a big fan of saying that none of us is as smart as all of us.”