Horseshoe Kidney (Renal Fusion) Treatment in Delhi, India

In many cases, people with horseshoe kidneys do not experience any symptoms and may not even be aware of the condition. However, some individuals with renal fusion may experience certain signs and symptoms, which can include:

• Abdominal or flank pain
• Blood in the urine
• Frequent urinary tract infections
• Urinary tract obstruction
• Kidney stones
• Hydronephrosis (swelling of the kidney due to urine backup)
• High blood pressure
• Developmental abnormalities of the urinary tract
• Increased risk of kidney cancer
• Anaemia

It's important to note that these symptoms are not specific to horseshoe kidney and can be indicative of other medical conditions as well. If you experience any of these symptoms or have concerns about your kidney health, it's recommended that you speak with a healthcare provider for an accurate diagnosis and appropriate treatment.

The exact cause of renal fusion, or horseshoe kidney, is not well understood. However, several factors have been proposed to contribute to the development of this condition.

Here are some possible causes of renal fusion:

• Foetal development- Horseshoe kidney is believed to develop during foetal development when the two kidneys fuse together instead of separating and ascending to their normal position in the upper abdomen. This can occur due to a disruption in the normal embryonic development of the kidneys.
• Genetic factors- Some studies suggest that genetic factors may play a role in the development of renal fusion. It is more commonly seen in people with genetic conditions like Turner syndrome, trisomy 18, and trisomy 13.
• Environmental factors- Exposure to certain environmental factors during pregnancy, such as drugs or toxins, may also increase the risk of horseshoe kidney.
• Other medical conditions- Horseshoe kidney can also be associated with other medical conditions, such as kidney or urinary tract abnormalities, Down syndrome, or Ehlers-Danlos syndrome.

The doctors often discuss symptoms and medical history at the first visit. They also enquire about family history and perform a physical examination. Some tests that they may recommend are:

• Renal ultrasound (sonography): A painless test that creates images of renal tissues to evaluate for anomalies. The transducer is placed and moved over the abdomen of the kidney area. An ultrasound image of the kidney can be seen on a video screen, and its dimensions are assessed. Also, any anomaly, such as a stones, tumours or cysts, can be detected with this test.
• Voiding cystourethrogram (VCUG): A VCUG provides X-rays of the urinary tract. The images obtained after the test help evaluate the presence of any reverse flow of urine into the ureters and kidneys.
• Intravenous pyelogram (IVP): This imaging test uses an X-ray to evaluate the urinary tract. A contrast dye is injected to view the results on the film. An IVP also displays the rate and path of the flow of urine through the urinary tract.
• Blood tests: They are done to detect any abnormalities in renal function.
• Urine test: This test helps evaluate blood and protein in the urine and the presence of any signs of infection.

There is no known cure for renal fusion or horseshoe kidney. However, treatment options are available to manage the symptoms and complications associated with this condition. The treatment plan for renal fusion depends on the severity of the symptoms and the presence of any associated medical conditions. Here are some treatment options that may be recommended:

Medications

Medications may be prescribed to manage pain, high blood pressure, or urinary tract infections.

Surgery

In certain cases, surgery may be recommended for people with renal fusion or horseshoe kidney. The surgical options will depend on the specific symptoms and complications of the condition. Here are some surgical options that may be considered:

• Stone removal

  People with horseshoe kidney are more prone to developing kidney stones due to the abnormal shape of the kidneys. If a kidney stone causes significant pain or blockage, surgery may be required to remove it.

• Urinary tract obstruction

  Horseshoe kidney can cause urinary tract obstruction in some cases, leading to a backup of urine and kidney damage. Surgery may be required to remove the blockage and improve urine flow.

• Cancer removal

  People with horseshoe kidney have a slightly higher risk of developing kidney cancer than the general population. If cancer is detected, surgery may be required to remove the affected part of the kidney.

• Correcting associated conditions

  Horseshoe kidney can be associated with other medical conditions, such as vesicoureteral reflux, leading to recurrent urinary tract infections. Surgery may be recommended to correct these associated conditions and prevent further complications.

Lifestyle modifications

Certain lifestyle modifications, like staying well-hydrated and maintaining a healthy diet, may help manage symptoms and reduce the risk of complications.

Monitoring

Regular monitoring of kidney function, blood pressure, and other associated medical conditions may be necessary to prevent complications and manage the symptoms of horseshoe kidney.

The risk factors for horseshoe kidney are:

• Problems in the cardiovascular system
• Problems in the central nervous system
• Issues with the genitourinary system
• Hydronephrosis
• Kidney stones
• Wilms tumour
• Renal cancer
• Polycystic kidney disease
• Spina bifida

Individuals with horseshoe kidneys are at a higher risk of developing:

• Vesicoureteral reflux (VUR) is when urine flows backwards from the bladder toward the kidneys.
• Renovascular hypertension
• Ureteropelvic junction (UPJ) obstruction - part of the kidney and urine drainage is blocked.
• Wilms tumour
• Hydronephrosis - accumulation of urine in the centre of the kidneys. This accumulation results in swollen kidneys.
• Polycystic kidney disease
• Blood in the urine or hematuria
• A mass or lump in the abdomen
• Flank pain (pain in the sides of the body)

Horseshoe kidney does not result in any serious health ailments. However, managing symptoms is essential. A child with renal fusion can live a full and active life. Further, people with renal fusion may be at a higher risk of developing cancer or tumours and hence, need regular check-ups with the doctor.

Reviewed by Dr. Anant Kumar, Chairman - Urology Renal Transplant and Robotics of Max Saket Complex, Max Vaishali and Uro - Oncology of MSSH Saket, Urology, Kidney Transplant, Robotic Surgery, Uro-Oncology on 27-Mar-2023.