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The horseshoe kidney (ren arcuatus) is one of the most common kidney defects and the most common form of fused kidney. What are the causes of the horseshoe kidney? What are the symptoms of such a kidney defect and how is the treatment performed?
Horseshoe kidney(Latinren arcuatus , Englishhorseshoe kidney ) is the most common the form of a fused kidney. It is formed in the first 2 months of fetal life as a result of joining the lower poles of both terminal kidneys. It occurs in 1 in 400-700 liveborn babies, more often in boys. It often has atypical and complicated vascularization.
The disadvantage is that the lower poles of the kidneys are connected by a staph, which may be connective tissue or more often parenchymal in nature. Sometimes it contains calyxes of the lower group of both or one kidney. As much as 95% of the connection concerns the lower poles of the kidney, and only 5% of its upper poles.
Horseshoe kidney: symptoms and diagnosis
In about 1/3 of cases, the course remains asymptomatic. A further 1/3 of patients may develop sub-pyelopathy, which promotes urinary retention, the development of urinary tract infections and the formation of stones within it.
Due to the multitude of varieties of vascularization of the horseshoe kidney, it is possible to reappear, due to pressure on the ureter by vessels running to the isthmus, of disturbances in the outflow of urine from the kidney with the subsequent development of hydronephrosis and kidney stones. Often times, a very thick strait also causes urine retention. About 80% of children suffering from this defect have various degrees of dilatation of the renal calyco-pelvic system. Additionally, hypertension may develop.
Some patients may also have malformations of the skeletal, cardiovascular and digestive systems, as well as other defects of the urinary system.
The diagnosis of the horseshoe kidney is based on imaging tests - ultrasound or urography. The urographic examination shows a characteristic image of the calyx - it reaches medially, beyond the ureter crossing it. The oblique urographic images may show the arched course of the ureter in the section of its modeling on the isthmus. Other possible radiographic features include an imperfect turn and tapering of the long axes of both kidneys is incorrectdown.
Horseshoe kidney: treatment
Depending on the indications, the treatment of the horseshoe kidney is surgical. The operation consists in separating the isthmus as much as possible and restoring the correct anatomical conditions - the problem may be incorrectly running and too short vessels. In the presence of urinary tract infections, antimicrobial treatment or prophylactic treatment should be applied. In the case of urolithiasis in the area of the cup-pelvic system, the following applies, inter alia, percutaneous nephrolithotripsy - a procedure involving the removal of stones through a renal fistula produced by the kidney puncture method. Another way to treat urolithiasis is lithotripsy using ultrasound waves or ureterorenoscopy.
ImportantCongenital kidney defects are diseases resulting from abnormalities in the development of this organ's parenchyma during fetal organogenesis or disorders in utero of the mechanisms responsible for bringing the kidneys to their final location - the retroperitoneal space. These defects are often caused by monogenic defects or chromosomal mutations.