HORSESHOE KIDNEY

Horseshoe Kidney

Description

• Horseshoe kidney is a congenital anomaly where the two kidneys are fused together at the lower poles by a band of tissue called the isthmus.
• It accounts for 0.25-0.45% of the population.
• The fusion can be complete or incomplete.

Types

• Complete fusion: The two kidneys are completely fused together.
• Incomplete fusion: The two kidneys are not completely fused together.
• Pelvic fusion: The fusion occurs in the pelvis region.
• Ureteropelvic fusion: The fusion occurs between the ureters and the pelvis.

Clinical Significance

• Horseshoe kidney can cause various complications such as:
  • Ureteropelvic junction obstruction
  • Hydronephrosis
  • Pyelonephritis
  • Renal calculi
  • Hypertension
• It can also cause pain, abdominal distension, and hematuria.

Radiological Diagnosis

• Ultrasound: Horseshoe kidney can be diagnosed using ultrasound, which shows a characteristic "horse-shoe" shape.
• Intravenous urography (IVU): IVU can also diagnose horseshoe kidney, showing a characteristic "S" or "C" shape.
• CT scan: CT scan is the most sensitive and specific method for diagnosing horseshoe kidney.

Typical Radiological Findings

• The kidneys are fused together at the lower poles.
• The isthmus can be seen as a band of tissue connecting the two kidneys.
• The renal arteries and veins are usually anomalous.
• The ureters can be tortuous or dilated.

Blood Supply

• The blood supply to the horseshoe kidney is usually anomalous, with the renal arteries arising from the aorta and the iliac arteries.
• The blood supply can be unilateral or bilateral.

Nerve Supply

• The nerve supply to the horseshoe kidney can be anomalous, with the renal plexus being abnormal.

Clinical Anatomy

• The clinical anatomy of horseshoe kidney is characterized by an anomalous renal position, shape, and size.
• The isthmus can be palpable on abdominal examination.

Management and Treatment

• Management of horseshoe kidney depends on the complications present.
• Surgical intervention may be required for complications such as ureteropelvic junction obstruction or pyelonephritis.

Homoeopathic Therapeutic Medicines

• Arsenic album: For renal colic and inflammation.
• Belladonna: For acute pyelonephritis and ureteral colic.
• Cantharis: For cystitis and urethritis.
• Nux vomica: For renal calculi and pyelonephritis.
• Pulsatilla: For renal colic and inflammation.
• Sanguinaria: For renal calculi and pyelonephritis.