Overview
Horseshoe kidney is a congenital anomaly characterized by the fusion of the lower poles of the kidneys, often associated with renal and extrarenal complications 16.Diagnosis
Imaging Studies: Ultrasound, CT, and urography are essential for diagnosis 41.
Common Renal Complications: Pelvicaliectasis, vesicoureteral reflux, duplex kidney, multicystic dysplastic kidney, renal stones, and hydronephrosis 1.
Extrarenal Associations: Gastrointestinal tract anomalies, vertebral anomalies, and other syndromes 1.Management
Conservative-Plastic Surgeries: Recommended to preserve renal function and ensure proper urine outflow 5.
Surgical Interventions: Hand-assisted laparoscopy can be effective for heminephrectomy in nonfunctioning moieties 2.
Treatment of Complications: Address specific issues like urinary tract infections, calculi, and hydronephrosis with appropriate interventions 6.Special Populations
Pediatrics: High incidence of renal complications; frequent monitoring and early intervention are crucial 1.
Twin Pregnancies: Horseshoe kidney can occur in monozygotic twins with variable concordance 3.Key Recommendations
Regular imaging and surveillance are essential in pediatric patients to detect renal complications early (Evidence: Moderate 1).
Conservative surgical techniques should be prioritized to preserve renal function in horseshoe kidney patients (Evidence: Expert opinion 5).
Consider horseshoe kidney in differential diagnoses when encountering preaortic masses on ultrasound (Evidence: Moderate 4).References
1 Je BK, Kim HK, Horn PS. Incidence and Spectrum of Renal Complications and Extrarenal Diseases and Syndromes in 380 Children and Young Adults With Horseshoe Kidney. AJR. American journal of roentgenology 2015. link
2 Dasgupta R, Shrotri N, Rane A. Hand-assisted laparoscopic heminephrectomy for horseshoe kidney. Journal of endourology 2005. link
3 Kalra D, Broomhall J, Williams J. Horseshoe kidney in one of identical twin girls. The Journal of urology 1985. link47012-1)
4 Mendelson DS, Mitty HA, Janus C, Cohen BA. Horseshoe kidney mimicking adenopathy. Urologic radiology 1983. link
5 Witeska A. Surgical treatment of patients with horseshoe kidney. International urology and nephrology 1982. link
6 Castro JE, Green NA. Complications of horseshoe kidney. Urology 1975. link90763-3)