Abnormal vascular supply of the horseshoe kidney: case report and review of the literature

Abstract

The horseshoe kidney (HSK) is a fusion anomaly of the kidneys with an incidence of 0.25% in general population, being more prevalent in men than women in a 2:1 relation. [1] This abnormality has been discovered clinically in all age groups ranging from fetal life to 80 years, but in autopsy series it is more prevalent in children. [2] This early age prevalence has been explained by high incidence of multiple congenital anomalies associated with the HSK, some of which are incompatible with longterm survival. [3] There is a wide variation in HSK vascular supply and excretory system. Renal arteries can originate from the abdominal aorta (Ao), the iliac arteries, and the inferior mesenteric arteries. Therefore it is important to know the clinical and surgical anatomy of the HSK. Renal transplants with HSK have been performed and for the proper management of this clinical condition it is necessary to understand the surgical difficulties and the most frequent clinical complications such as urolithiasis.In view of this important kidney anomaly, we report a case with a unusual arterial supply.

Horseshoe kidney: Morphologic features, embryologic and genetic etiologies, and surgical implications

“…which are not compatible with long-term survival (Harris et al, 2000;Cereda & Carey, 2012;Ranke & Saenger, 2001;Glodny et al, 2009;Scott, 2002;Basso, 2011) (Table 1).…”

“…However, a recent study (Sagi‐Dain et al, 2018) using chromosomal microarray analyses found that the frequency of abnormal results in fetuses with HSK was no different than that seen in the general population. HSK variants have been found to be higher in children as a concomitant presentation in newborns with multiple congenital variants, some of which are not compatible with long‐term survival (Harris et al, 2000; Cereda & Carey, 2012; Ranke & Saenger, 2001; Glodny et al, 2009; Scott, 2002; Basso, 2011) (Table 1).…”

Retroperitoneal Aortobifemoral Bypass by a Combination of Horseshoe Kidney and Aortoiliac Occlusive Disease with Stent Thrombosis

“…There could be wide variations in the arterial supply of the HSK (in approximately 80% of the cases) and the renal arteries (RAs) can originate from the abdominal aorta, the common iliac artery or from the inferior mesenteric artery. 3,4) HSK is usually asymptomatic and is an incidental finding. The renal anomaly can be infrequently combined with abdominal aortic aneurysm (in 0.12% of the patients) and the coexistence of HSK and aortoiliac occlusive disease (AIOD) is even more rare.…”

“…There could be wide variations in the arterial supply of the HSK (in approximately 80% of the cases) and the renal arteries (RAs) can originate from the abdominal aorta, the common iliac artery or from the inferior mesenteric artery. 3 , 4) …”

Horseshoe kidney and uretero-pelvic-junction obstruction in a pediatric patient. Laparoscopic vascular hitch: A valid alternative to dismembered pyeloplasty?

“…It occurs in 1 in 400-800 individuals with an incidence of 0.25% and a male predominance (2:1 relation). 1 The fusion area of the lower poles of both kidneys consists of parenchymal or fibrous tissue, also known as isthmus. The renal vessels thus develop an abnormal relation to the renal pelvis and ureters.…”