Note the bilaterally enlarged kidneys that nearly fill the abdomen below the liver. The histologic appearance in this case, coupled with the gross appearance, was consistent with autosomal recessive polycystic kidney disease (ARPKD). This infant died soon after premature birth at 23 weeks gestation from pulmonary hypoplasia as a result of oligohydramnios. The oligohydramnios resulted from markedly diminished fetal urine output as a consequence of polycystic kidney disease.