Thread by @iamnephrologist

🔥Horseshoe Kidney for Nephrologist (1/n)

⚡Most common renal fusion
⚡Ectopia+Malrotation+Vascular changes
⚡Prevalence 0.25%
⚡1522: da Carpi described 1st
⚡70% Lt dominant
⚡90%: Lower pole fusion

Pics-Surg Radiol Anat;J Ped Urol
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🔥Horseshoe Kidney for Nephrologist (2/n)

⚡Anatomical variations associated with HSK

Pics-Surg Radiol Anat
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🔥Horseshoe Kidney for Nephrologist (3/n)

⚡Congenital anomalies associated with HSK
👉Edward syndrome 67%
👉Turner syndrome 14%-20%
👉Down syndrome ~1%

Pics-Surg Radiol Anat
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🔥Horseshoe Kidney for Nephrologist (4/n)

⚡Diagnosis- Need to differentiate Functional, Fibrous & parenchymal isthmus
👉IVP can't differentiate
👉USG- fibrous isthmus difficult to diff
👉DSA/CT/MRI better

Pics-Surg Radiol Anat
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🔥Horseshoe Kidney for Nephrologist (5/n)

⚡Vascular abnormality imp to note before surgery
⚡Pre-op imaging must (Use 3D volume rendered CT)
⚡⬆️Frequency of RCC/WT
⚡VUR or PUJO👉HDN most common in symptomatic cases
🚫Symphysiotomy

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