KIDNEY FOUNDATION FOR CHILDREN

      SAVING YOUNG LIVES


ANSWERS. QUIZ 1

1.  diagnosis : Horseshoe Kidneys

Fusion of the kidneys at lower poles by an isthmus that may be fibrous or parenchymal. The fused kidneys are often incompletely ascended; blood supply may be from the iliac vessels.The kidneys are rotated so that  the pelvis lies anteriorlyand the ureters run over the isthmus

2. THE ISTHMUS

Identification of the isthmus and its continuity with the renal poles may not always be clear on USG. This may lead to a diagnosis of small abnormally placed kidneys.Occassionally the isthmus may be mistaken for a soft tissue prevertebral mass a a as the continuity with the kidneys may  not be obvious.CT scan,MRI or a DMSA scan helps to correctly identify the problem

3.RENAL TUMORS

 There is an increased risk of various tumours developing in the horseshoe kidney as compared to the normal kidney..Renal cell carcinoma is the most common; Wilm's tumour,adenocarcinoma,transitional cell carcinoma, malignant teratoma,,oncocytoma,angiolipoma and carcinoid have all been reported.

4.KARYOTYPING

  Girls with horshoe kidney should be examined for stigmata of Turner's syndrome  with  a XO karyotype  .Clinical clues .such as   short stature, widely                spaced nipples, wide carrying angle of the elbows ,webbing of the neck.may be present.




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