Horseshoe kidney natural history, complications and prognosis

The majority of patients with horseshoe kidney are asymptomatic and incidentally detected during renal imaging. However the outcome depends on associated urological problems.

• The majority of patients with horseshoe kidney are asymptomatic and incidentally detected during renal imaging. However the outcome depends on associated urological problems.

• Common complications of horseshoe kidney include:^[1]
  • Pelviureteric junction obstruction leading to hydronephrosis
  • Vesicoureteric reflux
  • Renal stones
  • Urinary tract infection
  • Increased risk of nephroblastoma and an approximately threefold to fourfold higher risk for cancer of the renal pelvis^[2]
  • Increased risk for extrarenal disorders that has been associated with horseshoe kidney including:^[3]
    • Gastrointestinal tract malformations
    • Vertebral malformations
    • CNS disorders
    • Cardiovascular disease
  • Increasing association with Wilm’s tumor
  • Blunt traumatic injury as low positioning prevents protection by ribs^[4]

• Prognosis is generally excellent in majority of the patients,without any intervention unless there is an associated complication.^[5][6]

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