Central Journal of Clinical Nephrology and Research Bringing Excellence in Open Access
Case Report *Corresponding author Luis Alberto Batista Peres, Department of Nephrology, State University of Western Parana, Street Vicente Machado, 2355, Paraná, Brazil, Tel: 55 Renal Transplantation in 45 30388010; Email: Submitted: 11 July 2017 a Patient with Polycystic Accepted: 10 August 2017 Published: 19 August 2017 Horseshoe Kidney - Case Report ISSN: 2379-0652 Copyright Francilayne Moretto dos Santos1, Luis Alberto Batista Peres2*, and © 2017 Batista Peres et al. 3 José Roberto Leonel Ferreira OPEN ACCESS 1FAG University Center, Brazil 2Department of Nephrology, State University of Western Parana, Brazil Keywords 3Department of Radiology, State University of Western Parana, Brazil • Horseshoe kidney • Polycystic kidney disease • Transplantion Abstract • Graftsurvival Polycystic horseshoe kidney is a very rare occurrence. A 47-year-old woman patient was admitted to hospital complaining of increased belly volume. Familial history was positive for horseshoe kidney and polycystic kidney. Computerized tomography showed enlarged kidneys with multiple cysts, fused by their lower poles and multiple liver cysts. She remained on dialysis for four years, being submitted to kidney transplantation with a related live donor, presenting normal renal function after nineteen months of follow up.
INTRODUCTION found, with perdition for the male gender and occurring about 0.25% of the population [2,3]. It is usually asymptomatic, but the Horseshoe kidney results of an anomaly fusion during affected individuals are more prone to a variety of complications embryogenesis, while the polycystic kidney is an autosomal such as renal lithiasis, ureteropelvic junction stenosis, dominant hereditary disorder. It is a very rare occurrence found renovascular hypertension, polycystic kidneys and polycystic both anomalies in the same patient. The incidence ranges of 1 in liver [3]. 134.000 to 1 in 8.000.0000 live births [1]. The polycystic kidney disease is an autosomal dominant CASE PRESENTATION hereditary disorder. It affects all ethnic groups worldwide with A 47-year-old woman was admitted to hospital complaining incidences ranging from 1 in 500 to 1 in 5000 births. About 5% of increased belly volume. At physical examination, palpation of the reported cases can be occurring without previous family of large lobulated mass occupying the entire abdomen. An history. It has as responsible genes: PKD1 on chromosome 16 abdominal ultrasonography revealed polycystic horseshoe and PKD2 on chromosome 4. Widely expressed in extra renal kidney and liver cysts. Computerized tomography showed -1 and polycystin-2, enlarged kidneys with multiple cysts, fused by their lower poles tissues and their codified proteins, polycystin pregnancy at age 15. Familial history: a brother with horseshoe kidneyand multiple and three liver daughters cysts. She hadwith been polycystic hypertensive kidney. sinceAt admission her first her renal function was noticed to be abnormal (serum creatinine of 2.1 mg/dl; creatinine clearance of 43 ml/min/1.73m2). It developed to advanced chronic kidney disease, undergoing hemodialysis for four years. Nineteen months ago she underwent kidney transplantation with a related living donation (daughter). Immunosuppression with prednisone and tacrolimus. In a follow up, normal renal function and tomography showed a increased in bilaterally with multiple cysts and fusion by the lower poles (Figure 1), liver cysts (Figure 2) and renal graft in the right iliac fossa (Figure 3). Figure 1 Computerized abdominal tomography showing bilateral DISCUSSION kidney enlarged, containing multiple cysts and fusion by their lower Horseshoe kidney is a renal fusion anomaly most common poles.
Cite this article: dos Santos FM, Batista Peres LA, Leonel Ferreira JR (2017) Renal Transplantation in a Patient with Polycystic Horseshoe Kidney - Case Report. J Clin Nephrol Res 4(5): 1075. Batista Peres et al. (2017) Email:
Central Bringing Excellence in Open Access respectively, are associated to cyst production, cerebral and aortic aneurysms, cardiac valvular abnormality and colonic diverticuli [4,5]. Until our knowledge, we found two cases with a polycystic horseshoe kidney submitted a renal transplant published in the literature. In both cases, a Nephrectomy bilateral before the transplantation was necessary. In our case the Nephrectomy was not necessary [6,7]. REFERENCES 1. Dial Transplant. 2007; 22: 652-653. Peres LA, Ferreira JR, Delfino V. Polycystic horseshoe kidney. Nephrol 2. Alamer A. Renal Cell Carcinoma in a Horseshoe Kidney: Radiology and Pathology Correlation. J Clin Imaging Sci. 2013; 3: 12. 3. Peres LAB, Ferreira J, Bader S. Rim em ferradura com cistos e ureter Figure 2 Computerized abdominal tomography showing liver único: relato de caso. J Bras Nefrol. 2010; 32: 416-417. enlarged and multiple cysts (Polycystic liver). 4. Brum FA, Becker M, Uglione A, Da Ros CT. Polycystic horseshoe kidney. J Urol. 1997; 158: 2229-2230. 5. Cnossen WR, Drenth JP. Polycystic liver disease: an overview of pathogenesis, clinical manifestations and management. Orphanet J Rare Dis. 2014; 9: 69. 6. pretransplant nephrectomy for polycystic kidneys, is it valid for horseshoeVerbelen T,kidney? Darius Transplant T, Pirenne Int. J, 2012; Monbaliu 25: 96-97. D. Decision making in 7. Trapp JD, Zukoski CF, Shelley HS, Goldner F. Nephrectomy for polycystic horseshoe kidney with successful cadaver renal allograft. South Med J. 1965; 58: 1370-1371.
Figure 3 Computerized abdominal tomography showing pelvic kidney graft, without particularities.
Cite this article dos Santos FM, Batista Peres LA, Leonel Ferreira JR (2017) Renal Transplantation in a Patient with Polycystic Horseshoe Kidney - Case Report. J Clin Nephrol Res 4(5): 1075.
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