Horseshoe kidney pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Most people with horseshoe kidneys are totally asymptomatic and their kidneys function normally throughout their lives. About quarter of cases are found incidentally, usually during a CT scan due to some other problem. Nonetheless, there are lots of other patients who are predisposed to certain medical sequelae due to the embrogenesis or intrinsic anatomical abnormalities.[1]

Pathophysiology

  • Most people with horseshoe kidneys are totally asymptomatic and their kidneys function normally throughout their lives. About quarter of cases are found incidentally, usually during a CT scan due to some other problem. Nonetheless, there are lots of other patients who are predisposed to medical sequelae due to the embrogenesis or intrinsic anatomical abnormalities. These issues include:
    1. Ureteropelvic junction obstruction : It is the most common problem in horseshoe kidney. It is caused by crossing of ureter over the fused isthmus leading to its obstruction.
    2. Kidney Stones : Stones usually occur when there is obstruction leading to decreased urine output and stasis of urine which create environment for stone formation.
    3. Recurrent infections : Again due to stasis of urine, because stasis of urine create medium for bacterial growth
    4. Hydronephrosis : Basically it is caused by back-flow of urine due to obstruction of ureteropelvic junction.
    5. Increased incidence of certain cancers such as renal cell carcinoma, Wilm's tumor and Carcinoid tumors.[2]

Genetics

  • No genetic determination of horseshoe kidney is known, although it has been seen in identical twins and in siblings within the same family.

Associated Conditions

Horseshoe kidney

Gross Pathology

On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Microscopic Pathology

On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

References

  1. Natsis K, Piagkou M, Skotsimara A, Protogerou V, Tsitouridis I, Skandalakis P (2014). "Horseshoe kidney: a review of anatomy and pathology". Surg Radiol Anat. 36 (6): 517–26. doi:10.1007/s00276-013-1229-7. PMID 24178305.
  2. Neville H, Ritchey ML, Shamberger RC, Haase G, Perlman S, Yoshioka T (2002). "The occurrence of Wilms tumor in horseshoe kidneys: a report from the National Wilms Tumor Study Group (NWTSG)". J Pediatr Surg. 37 (8): 1134–7. PMID 12149688.

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