Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital , Gyeonggi-do, Korea.
Nephrol Dial Transplant. 2021 Feb 20;36(3):498-503. doi: 10.1093/ndt/gfz217.
Horseshoe kidney (HSK) is a congenital disorder that is usually asymptomatic, but that increases the risks of kidney stones and infectious disease. However, renal outcomes such as end-stage renal disease (ESRD) in patients with HSK remain unclear.
In total, 146 patients with HSK (age of ≥20 years) from two tertiary hospitals were included in this study. Control individuals who underwent medical check-ups were selected by matching for age, sex, serum creatinine level, hypertension and diabetes. The hazard ratios (HRs) for the risks of ESRD and all-cause mortality were calculated after adjustment for multiple variables.
The proportions of HSK-related complications for obstruction, kidney stones, urinary tract infection and urogenital cancer were 26, 25, 19 and 4%, respectively. During the median follow-up period of 9 years (maximum 32 years), the incidence of ESRD was 2.6/10 000 person-years. The risk of ESRD in patients with HSK was higher than in control individuals [adjusted HR = 7.6; 95% confidence interval (CI) 1.14-50.47]. All-cause mortality did not differ between the two groups (adjusted HR = 0.6; 95% CI 0.08-4.29).
Patients with HSK are at risk of ESRD, which may be attributable to the high prevalence of complications. Accordingly, these patients should be regarded as having chronic kidney disease and require regular monitoring of both kidney function and potential complications.
马蹄肾（HSK）是一种先天性疾病，通常无症状，但会增加肾结石和传染病的风险。然而，HSK 患者的肾脏结局，如终末期肾病（ESRD），仍不清楚。
本研究共纳入了来自两家三级医院的 146 例 HSK 患者（年龄≥20 岁）。通过匹配年龄、性别、血清肌酐水平、高血压和糖尿病，选择了进行体检的对照个体。在调整了多个变量后，计算了 ESRD 和全因死亡率的风险比（HRs）。
HSK 相关并发症的比例分别为梗阻 26%、肾结石 25%、尿路感染 19%和泌尿生殖系统癌症 4%。在中位 9 年（最长 32 年）的随访期间，ESRD 的发病率为 2.6/10000 人年。HSK 患者发生 ESRD 的风险高于对照个体[调整后的 HR = 7.6；95%置信区间（CI）1.14-50.47]。两组之间的全因死亡率没有差异（调整后的 HR = 0.6；95%CI 0.08-4.29）。
HSK 患者存在 ESRD 风险，这可能归因于并发症的高发。因此，这些患者应被视为患有慢性肾脏病，需要定期监测肾功能和潜在并发症。
