Vascular and urological anomalies in children with horseshoe kidneys

Öz

Purpose: Horseshoe kidney is the most common fusion anomaly that congenital systemic and urological anomalies accompany most of the patients. In this study, we aimed to investigate its association with vascular anomalies and especially nutcracker syndrome along with accompanying urological and other systemic anomalies in children with horseshoe kidney. Materials and methods: Twenty-six patients are diagnosed with horseshoe kidney in our clinic and 22 healthy children of the same age and sex were included in the study. All children were prospectively evaluated using Doppler ultrasonography in terms of renal artery and renal vein flow velocities, lumen diameters and vascular anomalies and presence of nutcracker syndrome. Results: Urological anomaly was found in 50% of the children with horseshoe kidneys, and systemic anomaly in 44% of them. In Doppler ultrasonographic evaluations performed on patients to detect vascular pathologies and nutcracker syndrome; findings of nutcracker syndrome were present in 2 patients in the horseshoe kidney group, while they were detected incidentally in 1 patient in the control group. An accessory renal artery originating from the left common iliac artery was found in a case with horseshoe kidney, and a circumaortic left renal vein in one case. Conclusions: In our study in which we investigated nutcracker syndrome based on the presence of vascular anomalies accompanying horseshoe kidneys in children, nutcracker syndrome findings were found in similar numbers in both groups. We think that these children should be followed for a long time in terms of chronic kidney damage and vascular pathologies that may occur in adulthood.

Anahtar Kelimeler

• Horseshoe kidney
• child
• nutcracker syndrome
• vascular anomalies
• urological anomalies

Atnalı böbreği olan çocuklarda vasküler ve ürolojik anomaliler

Öz

Amaç: Atnalı böbrek, konjenital sistemik ve ürolojik anomalilerin çoğu hastaya eşlik ettiği en yaygın füzyon anomalisidir. Bu çalışmada atnalı böbrek anomalisi bulunan çocuklarda eşlik eden ürolojik ve diğer sistemik anomaliler yanında vasküler anomaliler ve özellikle nutcracker sendromu ile birlikteliğinin araştırılması amaçlandı. Gereç ve yöntem: Kliniğimizde atnalı böbrek tanısı alan 26 hasta ile aynı yaş ve cinsiyette 22 sağlıklı çocuk çalışmaya dahil edildi. Tüm çocuklar prospektif olarak renal arter ve renal ven akım hızları, lümen çapları ve vasküler anomaliler ve nutcracker sendromu varlığı açısından Doppler ultrasonografi ile değerlendirildi. Bulgular: Atnalı böbrekli çocukların %50'sinde ürolojik anomali, %44'ünde sistemik anomali saptandı. Vasküler patolojileri ve nutcracker sendromunu saptamak için hastalarda yapılan Doppler ultrasonografik değerlendirmelerde; atnalı böbrek grubunda 2 hastada nutcracker sendromu bulguları mevcutken, kontrol grubunda 1 hastada saptandı. Atnalı böbrek anomalili bir olguda sol ana iliak arterden köken alan aksesuar renal arter ve bir olguda da sirkumaortik sol renal ven saptandı. Sonuç: Atnalı böbrek anomalili çocuklara eşlik eden vasküler anomalilerin varlığından yola çıkarak nutcracker sendromunu araştırdığımız çalışmamızda, nutcracker sendromu bulguları her iki grupta da benzer sayıda bulundu. Bu çocukların erişkin dönemde ortaya çıkabilecek damar patolojileri ve gelişebilecek kronik böbrek hasarı açısından uzun süre takip edilmesi gerektiğini düşünmekteyiz.

Anahtar Kelimeler

• Atnalı böbrek
• çocuk
• nutcracker sendromu
• vasküler anomaliler
• ürolojik anomaliler

Kaynakça

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