An isolated finding of a horseshoe kidney is generally considered benign
About
- The renal masses are connected as their lower poles
- Usually by a fibrous /parenchymatous isthmus
Aetiology
- Commonest congenital renal anomaly 0.25% of population
- Associated with Turner syndrome, trisomies 13, 18, 21
- Associated with hypospadias, uterine and vaginal anomalies
Clinical
- May be no symptoms. Males>females
- Vague lumbar pain. Nausea, vomiting
- Calcium Oxalate Renal stones in 50%
- Can present at any age from child to elderly
- Recurrent UTI and stones and hydronephrosis
Investigations
- U&E: check renal function
- Renal USS : exclude hydronephrosis
- CT/MR may be useful
Pathology
- May lead to hydronephrosis & infections due to uteropelvic junction obstruction
- May lie close to inferior mesenteric artery
Management
- ABC, IV fluids for AKI. Urology referral for any obstruction/stones
- Antibiotics for infections. ESWL for stones. If fails need percutaneous surgery.