Transarterial renal embolization for enlarged horseshoe kidney

Area of Science:

• Nephrology
• Interventional Radiology
• Urology

Background:

• Horseshoe kidney is a congenital anomaly associated with an increased risk of renal dysfunction and obstructive uropathy.
• A 56-year-old male with horseshoe kidney presented with worsening abdominal fullness and end-stage renal failure requiring hemodialysis.
• Computed tomography revealed a markedly enlarged horseshoe kidney, suggesting significant obstruction or compressive effects.

Observation:

• The patient experienced progressive abdominal fullness despite initiating hemodialysis for end-stage renal failure.
• Transarterial embolization (TAE) was performed on the right renal arteries to reduce kidney size while preserving left renal function.
• Post-TAE imaging demonstrated decreased size in both components of the horseshoe kidney, with maintained daily urine output exceeding 1,000 ml.

Findings:

• TAE successfully reduced the volume of the enlarged horseshoe kidney.
• The intervention preserved adequate renal parenchyma and daily urine output.
• The findings suggest a potential mechanism of contralateral compression contributing to horseshoe kidney enlargement and dysfunction.

Implications:

• Transarterial embolization (TAE) presents a viable, less invasive treatment option for obstructive uropathy in horseshoe kidney patients.
• This approach may help manage renal dysfunction and associated symptoms in complex renal anomalies.
• Further research is warranted to evaluate the long-term efficacy and safety of TAE in horseshoe kidney management.