The formation of a so-called horseshoe kidney always occurs when the lower kidney poles of the two kidneys merge. Already in the womb, the kidneys are created thereby already somewhat shifted and no longer resemble the normal development. However, the ureters develop normally.
What is a horseshoe kidney?
When, during the development of an embryo in the womb, the two kidneys grow together at the bottom, it is called a horseshoe kidney. At times, only part of the kidneys may not have grown correctly. The formation of a horseshoe kidney therefore already occurs during embryonic development in pregnancy. It is a congenital kidney malformation that is either genetically determined or caused by external influences. Corrective interventions already during pregnancy cannot be performed. With the formation of a horseshoe kidney, the risk is quite high that the affected person will suffer more frequently from urinary tract diseases such as various infections in their further life. Kidney stones may also occur more frequently. However, many of those affected do not even know that they are living with a horseshoe kidney and have already been born with it, as it does not necessarily cause symptoms. Often, the kidneys can perform their function perfectly normally. For this reason, invasive interventions, treatments and therapies are often not necessary. Necessary, these measures are usually only when complaints occur.
Causes
Horseshoe kidney generally refers to an abnormality of the human kidneys. It is caused by genetic defects, that is, defects at the chromosomal level. Environmental factors may also be responsible for the development of horseshoe kidney. The horseshoe kidney exists from birth and is already formed during the embryonic phase in the womb. Both kidneys are fused together at the lower ends. They thus form the shape of a horseshoe, hence the name horseshoe kidney. This malformation is one of many in the area of the kidneys and occurs comparatively rarely, at 15 percent of all kidney malformations. Although both kidneys are fused together, they have separate renal and blood vessels. Also, as in people with normally developed kidneys, the urinary tracts are separate from each other. The bladder is also in a normal location. Boys are usually more often affected by the malformation of the horseshoe kidney than girls. Often, other organ anomalies occur in this context. Due to the fusion of kidney tissue, the kidneys of affected individuals are usually completely immobile. This increases the risk of damage to the kidneys during trauma and injury to the abdomen. Because it may be difficult to show the horseshoe kidney on imaging, affected individuals usually never learn of the presence of such a malformation.
Symptoms, complaints, and signs
In many cases, sufferers of horseshoe kidney do not experience any symptoms during their lifetime. However, the malformation may still have an impact on the body, and various symptoms may manifest. The main symptoms of horseshoe kidney include pain and uncomfortable feelings of pressure in the surrounding organs. This is caused by the pressure exerted on them by the malformed kidneys. It may also lead to disturbances in the gastrointestinal activity of the affected person. In rare cases, compression of the aorta may also occur. In this case, the symptoms manifest themselves in circulatory disturbances of the legs and feet, as well as numbness. Sometimes, compression of the inferior vena cava can also occur, and varicose veins appear. After many years, different diseases can also develop, which are due to the horseshoe kidney. These can be kidney stones or the formation of a so-called water sack kidney. In addition, a connection between the horseshoe kidney and the development of various tumors is suspected, which occur predominantly in the neck area.
Diagnosis and course of the disease
For the diagnosis of horseshoe kidney, the designated radiological examination methods in urology are used. These are ordinary sonography, i.e. ultrasonography, urography, computed tomography, and magnetic resonance imaging. In most cases, the presence of a horseshoe kidney is harmless.Therapy is not necessary in most cases. However, urinary outflow disorders, infections or kidney stones may occur. In these cases, a therapy for the horseshoe kidney must be started. It is of great importance that children with this kidney malformation have an increased risk of developing malignant kidney tumors. Specifically, this risk is increased six-fold in contrast to unaffected individuals.
Complications
Horseshoe kidney disease does not necessarily cause severe symptoms or lead to complications. In many cases, the patient experiences no discomfort and therefore no complications. In this case, direct treatment of the horseshoe kidney is also not necessary. However, the patient may still experience unpleasant feelings of pressure in the abdomen. The kidneys can also displace the surrounding organs or generally have a negative effect on them. The gastrointestinal tract is also often disturbed by the horseshoe kidney and does not function properly. Due to disturbances in blood circulation, it is not uncommon for cramps or numbness to occur. These not infrequently lead to severe restriction of movement. Likewise, the risk of tumors is greatly increased by the disease, so that the patient usually has to be examined more often. The diagnosis of horseshoe kidney is made relatively early and quickly, so that early treatment can be initiated. If symptoms occur, the horseshoe kidney can be treated surgically or removed completely. This does not lead to any further complications. Life expectancy is also not limited or reduced by consistent treatment.
When should you see a doctor?
A horseshoe kidney often does not cause any symptoms and therefore does not require medical treatment. However, if symptoms such as severe pain, an uncomfortable feeling of pressure in the abdominal smoke, or disturbances in gastrointestinal activity develop, a visit to the doctor is recommended. In case of circulatory disorders of the legs as well as numbness in the limbs, medical advice is required. This may be due to a compression of the aorta, which can lead to serious complications if left untreated. At the latest when varicose veins or signs of a water sack kidney are noticed, the family doctor or a nephrologist should be consulted. People suffering from cancer should discuss the above symptoms with the doctor in charge. Horseshoe kidney usually occurs in connection with a genetic defect. Parents of children diagnosed with such a defect should pay particular attention to noticeable symptoms. If in doubt, the child must be examined by a specialist. If the symptoms are severe, it is best to call the ambulance or the child should be taken to a specialist clinic.
Treatment and therapy
Standard treatment for malformations of the kidneys, such as horseshoe kidney, is surgery if discomfort occurs or if there are other symptoms and physical impairment. Sometimes surgery becomes necessary in children when the kidneys cause great pain at the fused site due to a bottleneck. In this case, the surgery is then performed directly at this site. In this case, the kidneys are fixed in a normal position. In rare cases, horseshoe kidney can also cause kidney dysfunction, which can then have a significant impact on the patient’s health. In this case, the affected half of the kidney or part of it is surgically removed. This is technically known as a heminephrectomy.
Outlook and prognosis
If no other impairments or disorders are present, the prognosis for a horseshoe kidney is favorable. In numerous patients, there are no lifelong health disorders or secondary diseases caused by the altered tissue structure. The kidneys perform comparable work to that of a healthy person. There is also no shortening of the lifespan. Nevertheless, some sufferers of a horseshoe kidney receive a worse prognosis. Due to the anomaly of the organ, there is an increased risk of developing urinary tract infections in the course of life. Although these can be diagnosed quickly and are easily treatable, they repeatedly affect health and thus well-being. If left untreated, inflammations in the organism can continue to spread unhindered in these patients. In addition, organ damage to the kidney can develop.Failure of kidney function becomes more likely. This threatens the need for a donor organ and potentially endangers life. Medical care should prevent further disease or permanent damage to the kidney. In severe cases, tumor disease develops. Patients with a horseshoe kidney are generally at increased risk of developing a kidney tumor. If it is not detected early and completely removed, the affected person may die prematurely.
Prevention
In principle, no preventive measures can be taken against the development of a horseshoe kidney. Because it is a congenital defect based on genetic causes or embryonic developmental disorders, it is not possible to counteract the formation of a horseshoe kidney during pregnancy.
Follow-up
In most cases, the measures of aftercare for a horseshoe kidney are severely limited. In this case, the affected person is dependent on prompt treatment in case the disease also leads to other complaints in the affected person’s other internal organs. Whether the horseshoe kidney will lead to a reduced life expectancy of the patient cannot be predicted in general. The focus is therefore on early detection of the disease, with the horseshoe kidney ideally being detected directly in the womb. Treatment of this disease is only given when the disease affects certain functions of the body. Therefore, affected parents should have their children regularly examined by a doctor to identify all body functions. In this case, the treatment is carried out by surgical intervention, which is usually without complications and relieves the symptoms of horseshoe kidney. After the surgery, the child should definitely rest and not exert himself. It is also necessary to refrain from stressful or from physical activities. If the disease is treated early, there are usually no complications or reduced life expectancy. In some cases, the disease may increase the risk of ureteral infections, so these should be especially avoided.
Here’s what you can do yourself
The classic horseshoe kidney often has no disease value, but is rather classified under the anatomical features. Many affected individuals have no symptoms, or get them late in life. In other cases, the presence of the horseshoe kidney can lead to functional disorders. Kidney function may be disturbed to the extent that, for example, there may be problems with urine drainage and excretion. Anyone affected by a horseshoe kidney should have regular check-ups with a doctor. In this way, possible complications can be detected and treated at an early stage. People who are endowed with this anatomical peculiarity can also take particularly good care of the health of their kidneys. A lifestyle that does not overload the kidneys is highly recommended. Those affected can, for example, refrain from excessive consumption of meat, especially very fatty meat. Also, stimulants such as alcohol, caffeine and nicotine should be avoided, as a large proportion of their substances are filtered out of the body by the kidneys. Painkillers such as headache medication or anti-inflammatories should also be taken very consciously and only if really necessary. All these substances place an above-average burden on the kidneys. If you want to take care of your health, you should drink a lot. Two to three liters of water, tea or other unsweetened beverages have a positive effect on kidney function.
