From the Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
Exp Clin Transplant. 2023 Jun;21(Suppl 2):49-52. doi: 10.6002/ect.IAHNCongress.12.
Horseshoe kidney or ren arcuatus is the most common renal fusion anomaly, with an incidence of 1:500 in the normal population and a male predominance of 2:1. In >90% of cases, the fusion occurs along the inferior pole. It may vary in location, orientation, and arterial and venous anatomy. In 1522, Berengario da Carpi described this renal malformation for the first time in his masterpiece "Isagogae breves" (Introduction to Anatomy). He reported the results of a postmortem examination in the public autopsy room of the University of Bologna, describing "kidneys that are continuous as if they were a kidney, with two emulsifying veins, two emulsifying arteries, two ureteral outlets." In 1564, Leonardo Botallo described and illustrated the features of this atypical anatomical representation, and later, in 1602, Leonard Doldius added further details by examining this anatomical feature during an autopsy. In 1761, Giovanni Battista Morgagni discussed this condition not only as a rare anatomical curiosity found only in necroscopy but also discussed its physiological aspect. In the nineteenth century, with the advent of renal surgery, the horseshoe kidney played a more important role in urological diagnosis and treatment, and its identification became more frequent. With the advent of pyelography, imaging reports of the horseshoe kidney allowed a more accurate representation of the anatomical variants, which was particularly useful in preoperative assessment and outcomes. Berengario da Carpi laid the foundation for a better knowledge of this anatomical anomaly. Five hundred years after the first report in the literature, relevant advances have been made in the management of complications associated with horseshoe kidney and in diagnosis, confirming the need to monitor individuals with this condition who are at higher risk of developing chronic kidney disease.
马蹄肾或肾弓形是最常见的肾融合异常，在正常人群中的发病率为 1:500，男性发病率为 2:1。在>90%的病例中，融合发生在下极。它可能在位置、方向以及动静脉解剖结构上有所不同。1522 年，Berengario da Carpi 在他的杰作《Isagogae breves》（解剖学入门）中首次描述了这种肾脏畸形。他报告了在博洛尼亚大学公开解剖室进行尸检的结果，描述了“肾脏连续如同一颗肾脏，有两条乳化静脉、两条乳化动脉、两个输尿管出口”。1564 年，Leonardo Botallo 描述并描绘了这种非典型解剖表现的特征，后来，在 1602 年，Leonard Doldius 在解剖时进一步详细检查了这个解剖特征。1761 年，Giovanni Battista Morgagni 不仅将这种情况讨论为一种仅在尸检中发现的罕见解剖学好奇心，还讨论了其生理方面。19 世纪，随着肾外科的出现，马蹄肾在泌尿外科的诊断和治疗中发挥了更重要的作用，其识别变得更加频繁。随着肾盂造影术的出现，马蹄肾的影像学报告可以更准确地描述解剖变异，这在术前评估和结果中特别有用。Berengario da Carpi 为更好地了解这种解剖异常奠定了基础。在文献中首次报道 500 年后，与马蹄肾相关的并发症的处理以及诊断方面取得了相关进展，证实需要监测患有这种疾病的人，因为他们更容易发生慢性肾脏病。
