Horseshoe Kidney (Renal Fusion): Causes & Treatment

Overview

• Horseshoe Kidney: A congenital condition where the kidneys fuse to form a horseshoe shape.
• Formation: Occurs during fetal development; kidneys form a U shape instead of two separate kidneys.
• Position: Sits lower in the pelvis, closer to the front of the body.
• Prevalence: Affects about 1 in 500 people; more common in males.
• Health Impact: Typically doesn’t cause serious health issues or affect life expectancy.

Associated Conditions

• Chromosomal Conditions: Down syndrome, Turner syndrome, Patau syndrome, Edwards syndrome.
• Non-chromosomal Conditions: Ellis-van Creveld syndrome, Fanconi anemia, Goltz syndrome, Kabuki syndrome, Pallister-Hall syndrome, VATER syndrome.

Symptoms and Causes

Symptoms

• Generally asymptomatic.
• Possible symptoms: Nausea, vomiting, frequent UTIs, pain during urination, kidney stones, abdominal pain, hematuria.

Causes

• Exact cause unknown; related to genetic developmental issues.

Complications

• Most common: Ureteropelvic Junction (UPJ) obstruction (in 33% of cases).
• Other complications: Vesicoureteral reflux, hydronephrosis, polycystic kidney disease, renovascular hypertension, increased risk of kidney cancer.

Diagnosis and Tests

• Often found incidentally during examinations for other conditions.
• Tests: Physical exam, urinalysis, kidney function tests (eGFR, BUN test, creatinine clearance test), imaging (ultrasound, VCUG, radionuclide scan, X-rays, MRI, CT scan).

Management and Treatment

• No cure but treatment for symptoms includes antibiotics for infections, surgery for kidney stones.
• Surgical removal of the kidney is uncommon.

Prevention

• No known prevention methods.
• Important to note that the condition is not caused by parental actions during pregnancy.

Outlook / Prognosis

• Generally good prognosis.
• Regular check-ups and monitoring are recommended.
• Care team may include pediatrician, nephrologist, urologist.

Living With Horseshoe Kidney

• Higher risk of kidney damage from physical injury.
• Recommendations: Wear a medical alert bracelet, avoid contact sports, use protective equipment.

When to See a Healthcare Provider

• If experiencing symptoms like abdominal pain, frequent UTIs, or kidney stones.

Questions for Healthcare Providers

• Confirmation of diagnosis, treatment options, necessity of surgery, cancer screening, preventive tests, use of a medical alert bracelet, kidney health maintenance.

Additional Common Questions

• Can donate a horseshoe kidney, though not common.

Summary by Cleveland Clinic

• Importance of understanding the condition and managing symptoms.
• Recommendations for lifestyle adjustments to prevent complications.
• Encouragement to consult healthcare providers for any symptoms or concerns.