Congenital Anomalies of the Kidney

CONGENITAL ANOMALIES OF THE KIDNEY

Renal agenesis

·            Bilateral agenesis is incompatible with life. Ultrasound shows oligohydramnios.

·            Affected fetuses typically also have Potter facies (flattened nose, posteriorly rotated ears, and recessed chin); talipes equinovarus (talus [ankle]+ pes [foot] and equino [heel] + varus [turned upward] = clubfoot); and pulmonary hypo-plasia.

·            In unilateral agenesis, the remaining kidney undergoes compensatory hyper-trophy. Patients often have adequate renal function and are asymptomatic.

Hypoplasia is failure of a kidney (usually unilateral) to develop to normal weight;the hypoplastic kidney has a decreased number of calyces and lobes.

Horseshoe kidney is a common congenital anomaly that is found in 1 in 600 abdom-inal x-rays. The kidneys show fusion, usually at the lower pole; affected individuals have normal renal function but may be predisposed to renal calculi.

Abnormal locations.The most common abnormal location is a pelvic kidney. Theectopic kidney usually has normal function. Tortuosity of ureters may predispose to pyelonephritis.