Horseshoe Kidney: a Review of Anatomy and Pathology

Overview

Journal Surg Radiol Anat

Specialties Anatomy & Histology
General Surgery
Radiology

Date 2013 Nov 2

PMID 24178305

Citations 55

Authors

Konstantinos Natsis

Maria Piagkou

Antonia Skotsimara

Vassilis Protogerou

Ioannis Tsitouridis

Panagiotis Skandalakis

Affiliations

Soon will be listed here.

Abstract

Horseshoe kidney (HSK) is the most common renal fusion, which is characterized by three anatomic anomalies: ectopia, malrotation and vascular changes. Patients with HSK are prone to a variety of complications, genitourinary and non-genitourinary. In this paper, the anatomy of HSK is delineated with a great emphasis on its blood supply. After reviewing the literature, the arterial supply patterns found by each author were categorized according to the classification system proposed by Graves. The majority of HSKs were found to be supplied by renal arteries derived from the abdominal aorta below the isthmus or by vessels originating from the common iliac arteries. In addition, the abnormalities associated with HSK are highlighted and classified in anatomical variations, congenital anomalies as well as in pathologic conditions related to HSK.

Citing Articles

Reviewing the complexities of horseshoe kidney: insights into embryogenesis and surgical considerations.

Nechita O, Badescu D, Popescu R, Rascu S, Petca R, Aurelian J J Med Life. 2025; 18(1):10-19.

PMID: 40071162 PMC: 11891615. DOI: 10.25122/jml-2024-0325.

Horseshoe kidney presenting with features of left ureteropelvic junction obstruction-insights into management: a case report and review of the literature.

Mwita P, Nhungo C, Alexandre A, Nsato S, Mmbando T, Mtaturu G J Med Case Rep. 2025; 19(1):12.

PMID: 39794851 PMC: 11724512. DOI: 10.1186/s13256-024-04981-7.

Intraperitoneal laparoscopic technique in trendelenburg position: an effective surgical method for pyelolithotomy, pyeloplasty, and heminephrectomy in patients with horseshoe kidneys.

Xiong M, Chen Z, Wang X, Jiang H, Luo Z, Liang G BMC Urol. 2024; 24(1):236.

PMID: 39468533 PMC: 11520055. DOI: 10.1186/s12894-024-01631-4.

Cytoreductive Nephrectomy Following Immunotherapy for Metastatic Renal Cell Carcinoma and IVC Tumor Thrombus Arising from a Horseshoe Kidney.

Fletcher S, Schendzielos R, Rezaee M, Lum Y, Singla N Kidney Cancer J. 2024; 22(2):46-52.

PMID: 39435380 PMC: 11492747.

Supine percutaneous nephrolithotomy in horseshoe kidney.

Proietti S, Di Pietro S, Oo M, Gisone S, Scalia R, Gaboardi F Cent European J Urol. 2024; 77(2):291-297.

PMID: 39345315 PMC: 11428371. DOI: 10.5173/ceju.2024.8.

References

Schubert R, Soldner J, Steiner T, Schubert J, Kaiser W . Bilateral renal cell carcinoma in a horseshoe kidney: preoperative assessment with MRI and digital subtraction angiography. Eur Radiol. 1998; 8(9):1694-7. DOI: 10.1007/s003300050615. View

Huang W, Ge G, Meng J, Xu Y . High bifurcation of abdominal aorta upon horseshoe kidney at the level of upper L2 vertebral body: a rare case report. Surg Radiol Anat. 2009; 32(6):605-8. DOI: 10.1007/s00276-009-0586-8. View

Ichikawa T, Sekiguchi T, Kawada S, Koizumi J, Endo J, Yamada Y . Study of the association between an anomalous superior vena cava and horseshoe kidney. Circ J. 2012; 76(5):1253-8. DOI: 10.1253/circj.cj-11-0874. View

Bietz D, MERENDINO K . Abdominal aneurysm and horseshoe kidney: a review. Ann Surg. 1975; 181(3):333-41. PMC: 1343858. DOI: 10.1097/00000658-197503000-00015. View

GRAVES F . The arterial anatomy of the congenitally abnormal kidney. Br J Surg. 1969; 56(7):533-41. DOI: 10.1002/bjs.1800560717. View

CUKIER J, Aubert J, Dufour B . [Retrocaval ureter and horseshoe kidney in a 6-year-old hypospadic boy]. J Urol Nephrol (Paris). 1969; 75(10):749-57. View

Cohn L, Stoney R, Wylie E . Abdominal aortic aneurysm and horseshoe kidney. Ann Surg. 1969; 170(5):870-4. PMC: 1387669. DOI: 10.1097/00000658-196911000-00022. View

Dajani A . Horseshoe kidney: a review of twenty-nine cases. Br J Urol. 1966; 38(4):388-402. DOI: 10.1111/j.1464-410x.1966.tb09725.x. View

Ferko A, Krajina A, Jon B, Lesko M, Voboril Z . Juxtarenal aortic aneurysm associated with a horseshoe kidney. Transfemoral endoluminal repair. Arch Surg. 1997; 132(3):316-7. DOI: 10.1001/archsurg.1997.01430270102021. View

10.

Stroosma O, Scheltinga M, Stubenitsky B, Kootstra G . Horseshoe kidney transplantation: an overview. Clin Transplant. 2000; 14(6):515-9. DOI: 10.1034/j.1399-0012.2000.140601.x. View

11.

BOATMAN D, CORNELL S, Kolln C . The arterial supply of horseshoe kidneys. Am J Roentgenol Radium Ther Nucl Med. 1971; 113(3):447-51. DOI: 10.2214/ajr.113.3.447. View

12.

OBrien J, Buckley O, Doody O, Ward E, Persaud T, Torreggiani W . Imaging of horseshoe kidneys and their complications. J Med Imaging Radiat Oncol. 2008; 52(3):216-26. DOI: 10.1111/j.1440-1673.2008.01950.x. View

13.

Shen H, Yang P, DU L, Lu W, Tian Y . Horseshoe kidney with retrocaval ureter: one case report. Chin Med J (Engl). 2012; 125(3):543-5. View

14.

Makita S, Yoshizaki T, Tabuchi N . A case of abdominal aortic aneurysm with horseshoe kidney. Ann Thorac Cardiovasc Surg. 2009; 15(2):129-32. View

15.

Bronshtein M, Kushnir O, Ben-Rafael Z, Shalev E, Nebel L, Mashiach S . Transvaginal sonographic measurement of fetal kidneys in the first trimester of pregnancy. J Clin Ultrasound. 1990; 18(4):299-301. DOI: 10.1002/jcu.1870180413. View

16.

Radermecker M, Van Damme H, Kerzmann A, Creemers E, Limet R . Association of abdominal aortic aneurysm, horseshoe kidneys, and left-sided inferior vena cava: report of two cases. J Vasc Surg. 2008; 47(3):645-8. DOI: 10.1016/j.jvs.2007.08.053. View

17.

Costa R, Schaal C, Navarro F . Neoplasia in horseshoe kidney with pyelic fusion and crossed single ureter. Int Braz J Urol. 2005; 30(4):319-20. DOI: 10.1590/s1677-55382004000400010. View

18.

Kehagias D, Gouliamos A, Vlahos L . Horseshoe kidney associated with anomalous inferior vena cava. Eur Radiol. 1999; 9(5):935-6. DOI: 10.1007/s003300050770. View

19.

Symes J, EADIE D . Horseshoe kidney and abdominal aortic aneurysm. Br J Surg. 1973; 60(3):243-5. DOI: 10.1002/bjs.1800600321. View

20.

Machin G, Popkin J, Zachs D, Newbigging J, Walther G, Bell D . Fetus with asymmetric parietal encephalocele, and hydrops secondary to laryngeal atresia. Am J Med Genet Suppl. 1987; 3:311-21. DOI: 10.1002/ajmg.1320280537. View