Duplex kidney: not just a drooping lily

Area of Science:

• Pediatric Radiology
• Urogenital System Development
• Medical Imaging

Background:

• Duplex kidneys are common congenital anomalies, often asymptomatic.
• Significant pathology and long-term morbidity can be associated with duplex kidneys.
• Limited literature exists on the comprehensive review of duplex kidney anomalies and complications.

Purpose of the Study:

• To review imaging findings of duplex kidney abnormalities in pediatric patients.
• To correlate imaging spectrum with contemporary literature.
• To understand the clinical significance and associated pathologies of duplex kidneys.

Main Methods:

• Retrospective review of radiology database in a tertiary pediatric center.
• Search for 'duplex' in patients under 16 years old (2006-2013).
• Analysis of 836 imaging studies across various modalities.

Main Results:

• 274 pediatric patients identified with duplex kidneys.
• 55.1% had no complications; nearly 50% presented with complications.
• Common complications included upper moiety obstruction and lower moiety vesicoureteric reflux; ultrasound was the primary detection modality.

Conclusions:

• Duplex kidneys are frequently diagnosed but nearly half of pediatric cases involve complications.
• Upper moiety obstruction (ureterocele) and lower moiety vesicoureteric reflux are the most prevalent complications.
• Ultrasound is the most effective imaging modality for early detection of duplex kidney complications in children.