Horseshoe Kidney

Definition
• Two distinct renal masses lying vertically on either side of the midline
& connected at their respective lower poles by a parenchymatous or
fibous isthmus that cosses the midplane of the body, forming a “U”
shape at the isthmus.
• Most common disorders seen horseshoe kidney are turner syndrome
and trisomy 18
Epidemiology
• Occurs in 0.25% of the population, or about 1 in 400 persons
• More common in males, 2:1
Etiology
• Mechanical fusion
• horseshoe kidney is formed during organogenesis, when the inferior poles of
these early kidneys touch, fusing in the lower midline. The theory of
mechanical fusion is valid for horseshoe kidneys with a fibrous isthmus.
• Teratogenic event
• abnormal migration of posterior nephrogenic cells, which then coalesce to
form the isthmus.
Clinical history
• Mainly asymptomatic – autopsy finding
• UTI and fever in neonates
• Nausea
• Abdominal discomfort
• Kidney stnes and UTI at greater frequency than those without renal
fusion
Diagnosis
• Renal USG
• Blood test
• Urine test
• Voiding cystourethrogram (VCUG)
• Intravenous pyelogram (IVP)
Complications
• Kidney stones
• Hydonephrosis
• Wilm’s tumor
• Renal cancer