- Horseshoe kidney is an development anomaly
- Is also referred as renal fusion
- In 1 out of 500 children
- occurs as a result failure of complete ascending up of the kidneys with the fusion of lower or upper poles
- As it ascends up from the pelvic area it get fused at the base forming an U shape/Horseshoe shape
- This is Because of the fusion of sub divisions of mesonephric duct
- Commonly seen in males than in females and the prevalence is seen higher in lower Poles when compare with the upper poles
- Common site for this horseshoe kidney is in front of vertebra where the isthmus ,( the blood supply is more ),where it communicates one kidney to the other,other site is in front of aorta Causes
- The causes unknown but it is developmental or genetic
- Other reasons for the cause might include ,as a result of environmental factors such as when the baby is exposed to toxins before birth such as drugs or alcohol or any substances Clinical features
- It Is a fixed, non mobile, firm mass present in the midline at the level of 4th lumbar vertebrae
- On percussion, it is resonant which indicates the horseshoe kidney with may be increased risk of infection ,stone formation and hydronephrosis and Tuberculosis
- Also commonly seen with patients having down syndrome ,Turner syndrome, Edward syndrome,patau syndrome or other congenital abnormalities.
- Also seen in non chromosomal conditions such as fanconi anemia ,goltz syndrome etc
- Not usually seen ,mostly asymptomatic
- Pain , nausea ,kidney stones ,urinary tract infections, difficulty during urination ,pain while urinating
- Moreover ,there is a increased risk of Kidney cancer if symptoms such as hematuria mass in abdominal region flank pain and pain during urination
Kidney functional test
- Basic tests include blood test and urine tests are included as a regular investigative procedure
- To check the functioning of kidneys,it is done to know the levels of estimated glomerular filtration rates , blood urea nitrogen and creatinine levels
- In intravenous urography it reveals medialization of lower calyces and curving of ureter which is seen in the shape of a “flower vase”
Ultrasound abdomen or renal sonography
- Is used as a supportive investigation to know the shape and size of kidneys in case to rule out the presence of cysts or swellings
- Sometimes the ureters will angulate causing the Urinary stasis which also increase of the infection and stone formation
Intravenous pyelogram or IVP
- It is indicated to know the path and rate of urine flow through the urinary tract
Voiding cystourethrogram or VCUG
- It is indicated to know the direction of flow of urine
- That’s means downwards towards bladder or reverse to kidneys
- RadioNuclide scan
- Magnetic resonance imaging (MRI) or computer tomography (CT)
- I Symptoms are not present the treatment is usually not recommended
- There is no particular treatment for horseshoe kidney and only the supportive treatment is advised
- Supportive Treatment includes prescription of antibiotics,pain relievers
- surgery is only indicated in presence of vesicular ureteral reflux
- Surgery is not the solution in case of pain
- Surgery is not indicated until and unless the abdominal aortic aneurysms are present
- Surgery is only indicated when the patient have possible better outcomes such as restore urinary flow with no obstruction , vesicular ureteral reflux and remove kidney stones is the solution for the cause
- If Abdominal aortic aneurysms are present then divide the isthmus between the kidneys to compromise the vascular blood supply
- Special attention should be maintain in children from avoiding playing sports or other vigorous exercises
- Vesicular ureteral reflux
- Retro pelvic obstruction
- Renal cysts
- Renal artery stenosis
- Kidney cancer
- Spina bifida
- Wilms tumors
Frequently asked questions
How to take care of children or adults with horseshoe kidney by themselves at home?
As the kidney is present close to the body surface it always need to be taken care with more attention without hurting it
Need to use the advantage or help of an emergency medical alert band always
Prevent children from playing sports
Consult nephrologist ,urologist for the further treatment of symptoms are no being better with time
How to prevent horseshoe kidney ?
There is no cure for the horseshoe kidney,it only can be prevented from getting worse
How do you notice horseshoe kidney and consult the health care provider?
Look for signs and symptoms such as hematuria or blood in urine ,frequent urinary tract infections ,pain in abdomen mass or swelling in abdominal region is seen
Is Horseshoe kidney normal and can you live a normal life ?
Yes you can lead an active life & also can have a normal life
As it occurs in 1 out of 500 children it is quite not often times affect the children
Can you remove a horseshoe kidney?
Yes ,the horseshoe kidney can be removed with the help of surgical intervention known as laparoscopic heminephrectomy
Is used to remove the benign tumors and malignancies that are associated with the horseshoe kidneys
The procedure is safe to perform on patient with horseshoe kidney with less complications
Can your horseshoe kidney be transplanted?
Yes ,horseshoe kidneys can be transplanted once it is divided into two kidneys
The division can be done by dividing into 2 kidneys to place it as two different recipients or in a single recipients as a unit
It totally depends on the vascularity the isthmus which connects the horseshoe kidneys in between
Can horseshoe kidney cause pain?
Horseshoe kidney causes pain but it is not much common in every individual with horseshoe kidney it only affects 5 to 7 out of 10 people suffering from this .
The pain relief medications are advised
Is there any diet restriction for a person suffering with horseshoe kidney?
There is no diet restriction for the person with horseshoe kidneys ,but a well balanced diet is highly recommended
Can a horseshoe kidney cause renal failure?
Horseshoe kidney do not lead to any renal failure but it only increases the risk of infections and renal stone formation
There is no evidence noticed
Why do horseshoe kidney has hydronephrosis
It occurs due to the structure and position abnormalities of the ureters which is quite commonly seen in horseshoe kidney patients
The possible cause might be renal stones,cysts, tumors or any kind of growth near the urinary tract/ureter.