Renal outcome of children with horseshoe kidney: a single-center experience

Area of Science:

• Pediatric Nephrology
• Urology
• Congenital Abnormalities

Background:

• Horseshoe kidney (HSK) is a common congenital renal anomaly.
• Understanding the associated clinical features and long-term renal outcomes in children is essential for appropriate management.

Purpose of the Study:

• To evaluate the clinical characteristics of pediatric patients with horseshoe kidney.
• To identify associated urological and systemic abnormalities.
• To assess the renal consequences and risk factors for chronic kidney disease (CKD) progression in children with HSK.

Main Methods:

• Retrospective review of medical records of 41 children diagnosed with HSK between 2004 and 2014.
• Analysis of clinical features, associated anomalies, urinary tract infections (UTIs), surgical interventions, and renal outcomes including renal scarring (RS), proteinuria, hypertension, and CKD.

Main Results:

• The study included 41 children (53.6% female) with a median follow-up of 48 months. Associated urinary tract abnormalities were found in 43.9% of patients, and 19.5% had bladder dysfunction. UTIs occurred in 41.4%, and 17% required surgery. Renal scarring (RS) developed in 24.4%, proteinuria in 14.6%, hypertension in 9.8%, and CKD in 7.3%.
• Proteinuria, hypertension, and RS were independently associated with CKD.
• HSK was incidentally detected in 29.3% and prenatally diagnosed in 12.2% of cases.

Conclusions:

• Children with HSK require comprehensive evaluation for associated urological and non-urological abnormalities.
• Vigilant follow-up is recommended to monitor for urinary tract infections and renal scarring.
• Proteinuria, hypertension, and the presence of renal scarring are key indicators for CKD progression in pediatric HSK patients.