Nephrology Center, Toranomon Hospital Kajigaya, Takatsu, Kawasaki, Kanagawa 213-8587, Japan.
Clin Exp Nephrol. 2010 Apr;14(2):180-4. doi: 10.1007/s10157-009-0248-5. Epub 2009 Dec 15.
A 56-year-old Japanese man was admitted to our hospital with abdominal fullness in June 2006. He had been diagnosed as having a horseshoe kidney by computed tomography in January 2002. At that time, renal dysfunction (serum creatine: 2.0 mg/dl) was detected. Even after hemodialysis was started for end-stage renal failure in March 2006, his abdominal fullness became progressively worse. CT scanning showed a markedly enlarged horseshoe kidney. Transarterial embolization (TAE) was performed via the right renal arteries with 14 platinum microcoils; the left renal arteries were not embolized in order to preserve sufficient parenchyma and a urine volume of more than 1,000 ml daily. Two years after TAE, a decrease in the size of the left kidney was noted along with the right kidney. However, urine output was still more than 1,000 ml daily. It is possible that one kidney compressed the contralateral kidney, resulting in enlargement of both components of the horseshoe kidney and renal dysfunction. TAE may be a useful option for obstructive uropathy in patients with horseshoe kidney, which has conventionally been treated surgically.
一位 56 岁的日本男性于 2006 年 6 月因腹部饱胀入住我院。他于 2002 年 1 月通过计算机断层扫描被诊断为马蹄肾。当时，发现肾功能不全（血清肌酐：2.0mg/dl）。即使在 2006 年 3 月因终末期肾衰竭开始血液透析后，他的腹部饱胀感仍逐渐加重。CT 扫描显示明显增大的马蹄肾。通过右肾动脉进行经动脉栓塞术（TAE），共使用了 14 个铂金微线圈；左肾动脉未栓塞，以保留足够的肾实质和每天超过 1000ml 的尿量。TAE 两年后，发现左肾的大小减小，而右肾增大。然而，每天的尿量仍超过 1000ml。可能是一侧肾脏压迫对侧肾脏，导致马蹄肾的两个组成部分增大和肾功能不全。TAE 可能是马蹄肾梗阻性尿路病的一种有效治疗选择，传统上需要手术治疗。
