Urinary Tract Infections in Children with Horseshoe Kidneys: A Single-Center with 5 Years Experience

Abstract

Objective: Horseshoe kidneys is the most common congenital fusion abnormality of the urinary tract. Patients with this anomaly have additional urological or systemic abnormalities. In this study, we aimed to evaluate the clinical and radiological features, additional abnormalities, and frequency of urinary tract infection (UTI) of patients with horseshoe kidneys who were admitted to our clinic over the last 5 years and followed-up at our institution. Material and Methods: All patients with horseshoe kidneys who were < 18 years of age and had been admitted for the first time in the last 5 years or followed-up for at least 6 months in Ondokuz Mayis University, Pediatric Nephrology Department, were enrolled in the study. The medical records of each patient were reviewed for demographic features, clinical and laboratory findings, and radiological and scintigraphic evaluation results. Data were analyzed using SPSS for Windows (version 15). Results: A total of 66 pediatric patients (40 males and 26 females) were enrolled in the study. The median age of the patients was 2.8 (0.1-16.2) years at the time of diagnosis. Horseshoe kidneys were detected incidentally in 26 (39.4%) patients when performing ultrasonography for any other reason. The most common (21.2%) presentation symptom was UTI in symptomatic patients. Twenty-three (35%) patients had at least one UTI during their lives. Furthermore, 52% of patients with UTI had recurrent UTIs and 33% of them had lower urinary tract dysfunction (LUTD). The frequency of LUTD in patients with horseshoe kidneys who had recurrent UTIs was borderline significantly higher than that in patients without recurrent UTIs (p=0.050). Conclusion: Urinary tract infection (UTI) is common in patients with horseshoe kidneys. It is important to investigate the presence of LUTD in patients with recurrent UTIs. Recurrence of UTI can be largely prevented in these patients with proper treatment and close follow-up. (J Pediatr Inf 2015; 9: 108-13)