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2012年10月24日星期三

horseshoe kidney in children


The horseshoe kidney is the most common type of renal fusion anomaly. It consists of two distinct functioning kidneys on each side of the midline, connected at the lower poles by an isthmus of functioning renal parenchyma or fibrous tissue that crosses the midline of the body.
Horseshoe kidney occurs in 1 per 400-800 live births. The true incidence probably lies somewhere between these two extremes. Horseshoe kidney is twice as common in males as in females. No genetic determinant is known, although it has been reported in identical twins and in siblings within the same family.
The complications are as follows:
Kidney stone can be seen in children with horseshoe kidney. If the stones remain in the kidneys, the children usually do not have symptoms. However, if the stones pass through the urinary tract, the children will have the following symptoms:
Fever and chills
Cloudy urine
Increased urination
Flank pain
Blood in urine
Sweating
Nausea and vomiting
Cloudy urine
Hydronephrosis
Kidney structure abnormality can affect the excretion of urine from body, leading to urinary tract obstruction. It can enlarge kidneys and damage kidneys gradually. If hydronephrosis occurs, the following symptoms will occur:
Urinary tract infection
Decreased urine output
Body weight again due to retention of fluids
Abdominal mass
Urinary tract infection is commonly seen, but is usually uncommon in children under the 5 years. This condition is more common in girls than boys. Without control, it may affect kidneys directly to cause serious kidney infection.
In fact, about one-third of children with horseshoe kidney do not develop symptoms or complications. If the symptoms and complications can be controlled well, the patients can avoid developing renal failure.

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