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Horse Shoe Kidney

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Horse shoe Kidney was first recognized during an autopsy De Carpi in 1521. This anomaly consisits of two distinct renal masses lying vertically on either side of midline and connected at their respective lower poles by a parenchymatous or fibrous isthmus that crosses the mid plane of the body. This isthmus lies at the level of 4th lumbar vertebra just beneath the origin of inferior mesenteric artery in about 40% of cases. Fusion of upper poles instead of the lower poles results in an inverted horse Shoe Kidney which constitute 5-10% of all Horse-Shoe kidneys, (i.e. in 95% of HSK, fusion is at lower poles). HSK is found more commonly in males by a 2:1 margin. Summary & Conclusion: The abnormality originates between 4th and 6th weeks of gestation, after the ureteral bud has entered the renal blastema. Boyden (1931) postulated that at the 14 mm stage (4.5 weeks) the developing metanephric masses lie close to one another, any disturbance in their relation ship may result in joining at their inferior poles. Usually the fusion of the both kidneys occurs before they have rotated on their long axis ,thus pelvis and ureters of HSK are being usually placed anteriorly. Rarerly, fusion occurs after some rotation had already taken place in which case the pelves are anterimedialy placed.

Perspectives

Horse shoe Kidney was first recognized during an autopsy De Carpi in 1521. This anomaly consisits of two distinct renal masses lying vertically on either side of midline and connected at their respective lower poles by a parenchymatous or fibrous isthmus that crosses the mid plane of the body. This isthmus lies at the level of 4th lumbar vertebra just beneath the origin of inferior mesenteric artery in about 40% of cases. Fusion of upper poles instead of the lower poles results in an inverted horse Shoe Kidney which constitute 5-10% of all Horse-Shoe kidneys, (i.e. in 95% of HSK, fusion is at lower poles). HSK is found more commonly in males by a 2:1 margin. Summary & Conclusion: The abnormality originates between 4th and 6th weeks of gestation, after the ureteral bud has entered the renal blastema. Boyden (1931) postulated that at the 14 mm stage (4.5 weeks) the developing metanephric masses lie close to one another, any disturbance in their relation ship may result in joining at their inferior poles. Usually the fusion of the both kidneys occurs before they have rotated on their long axis ,thus pelvis and ureters of HSK are being usually placed anteriorly. Rarerly, fusion occurs after some rotation had already taken place in which case the pelves are anterimedialy placed.

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This page is a summary of: Horse Shoe Kidney, Indian Journal of Anatomy, January 2018, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ija.2320.0022.7518.10.
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