Double kidney. What is doubling of both kidneys?

Congenital kidney anomalies are not at all uncommon in nephrology, especially in pediatrics. In terms of prevalence, the leading position is occupied by such an anomaly as kidney duplication, which is a congenital pathology, since it develops during the period of intrauterine development of the fetus.

According to medical observations, kidney duplication in a child is diagnosed accidentally during a scheduled or unscheduled ultrasound examination. In girls, this anomaly occurs twice as often as in boys. The pathology may affect one or both lobes of the organ, manifest itself on both sides, not manifest itself at all, or provoke serious complications in the functioning of the urinary system and internal organs of the child.

Kidney duplication, what is it, how does the disease manifest itself, what treatment methods does modern nephrology offer and how to prevent the development of an anomaly? All parents who are planning a pregnancy or are already pregnant should know the answers to these questions.

What is kidney duplication?

Kidney duplication is an abnormal growth of an organ. During the development of the disease, the kidney doubles, its one or two lobes form three or four organs. Pathological organ growth in children develops during the period of active organogenesis in the first trimester of pregnancy.

Externally, a double kidney looks like fused organs that have their own circulatory system. The pathology can affect the left or right kidney, but in 10% of cases the organs on both sides are doubled. Duplication of the right kidney is much more common than the left one. As practice shows, double kidneys in a newborn or older child do not cause much discomfort. A person can live most of his life with an anomaly without knowing about it. In some cases, this condition increases the risk of developing pathologies of the urinary system, which threatens the development of diseases of the pelvic system.

This photo shows the main shapes

Having information about what double kidneys are, it is important to know what are the causes of the anomaly?

Causes

Abnormal growth of the kidneys refers to intrauterine pathologies of the embryonic period. The epidemiology of the disease is based on two main factors: teratogenic and genetic. The exact reasons for the abnormal growth of the organ are not known, but there are still several factors that increase the risk of developing pathology:

maternal ionizing radiation in the first trimester of pregnancy;
the use of potent drugs during the embryonic development of the fetus;
avitaminosis;
heredity;
alcohol abuse;
smoking.

There are other reasons that can disrupt the development of the fetus, provoke a violation of cell division, the structure of chromosomes, with the subsequent formation of kidney anomalies.

Types of anomaly

In pediatric nephrology, pathology is divided into two main types: complete or incomplete.

With complete doubling of the kidney, two lobules are present, while the renal pelvis of one lobe is underdeveloped. The pelvis has separate ureters that empty into the bladder. In some cases, there is an abnormality in which the ureter is discharged into the urethra. Despite the abnormal structure, the lobes of the organ can filter urine.

Incomplete doubling of the kidney is much more common, and with equal frequency it can damage the right or left lobe of the organ. Sometimes two pelvises are formed, but the pelvis system is poorly developed. Incomplete doubling of the left kidney leads to an abnormal enlargement of the organ; its structure is mostly asymmetrical, with the upper part being less developed than the lower.

Complete duplication of the kidney and ureter

Symptoms of pathology

With partial or complete doubling of an organ, clinical signs may be completely absent or diagnosed completely by chance during an ultrasound examination. In some cases, the anomaly is not detected, there are no symptoms, and the child can live with the pathology for many years. An exception to this condition is inflammation of the kidney tissue. Then the symptoms are pronounced, the child will have the following signs of the disease:

complaints of frequent headaches;
pain when urinating;
difficulty urinating;
increased weakness;
periodic increase in body temperature;
cloudy urine;
feeling of pain in the lower back.

A characteristic sign of the inflammatory process, when the kidney tissue doubles, is the appearance of pain in the lumbar region, which is mainly aching in nature. During the acute period of the disease, there is an elevated body temperature of up to 40 degrees, swelling of the face and limbs. Such symptoms should be a reason to consult a nephrologist and undergo an ultrasound scan.

Complications

The anomaly in which the organ doubles does not pose any threat to health, but still such children are at risk for developing diseases of the urinary system. It is known that with this anomaly, 30% of patients develop in older age. The risk of complications increases with the addition of a bacterial infection, which can lead to the manifestation of diseases such as:

kidney tuberculosis;

To reduce the risk of complications, a child who has been diagnosed with this pathology should periodically visit a nephrologist, undergo an ultrasound examination, and undergo laboratory tests.

Diagnostics

If the development of an anomaly is suspected, the doctor prescribes a number of laboratory and instrumental studies that can be performed on both adults and children.

Urography.
Ultrasound of the kidneys.
Dopplerography.
Urine and blood analysis.
Cystoscopy.

The doctor may prescribe other research methods that will help to obtain a complete picture of the disease, recognize pathology, and possible risks of complications. Based on the diagnostic results obtained, treatment tactics are prescribed.

Treatment methods

In the absence of morphological changes in the tissues of the organ, treatment is not carried out. Therapy can be prescribed only when both lobes of the organ are affected or an inflammatory process is associated with the anomaly.

If there are severe morphological changes in the organ, the patient may be prescribed heminephrectomy. The operation consists of removing one half of an organ lobe and has a good prognosis. During the postoperative period, the patient must strictly follow all the doctor’s recommendations.

For pathology with double kidneys, there is no conservative treatment, but the doctor can prescribe symptomatic treatment that will help improve the functioning of the urinary system, and in the presence of inflammation, relieve symptoms and reduce the risk of complications. When a bacterial infection occurs, the following may be prescribed:

Antibiotics.
Anti-inflammatory drugs.
Uroseptics.
Immunoboosting medications.
Antispasmodics.

When drug treatment does not bring the desired results, inflammatory reactions in the tissues of the urinary system are repeated several times a year, the doctor recommends surgery.

Patients with a history of pathology are advised to adhere to proper nutrition, avoid heavy physical labor, and avoid hypothermia.

Many parents are interested in whether children with congenital kidney anomalies are accepted into the army. It all depends on the final diagnosis. If the congenital anomaly does not interfere with the functioning of the urinary system and does not manifest itself in any way during life, then there will be no indication for a deferment from the army. In case of constant infectious exacerbations, the medical commission will issue a conclusion on unsuitability for military service.

Prevention

It is easier to prevent a congenital kidney abnormality than to live with it throughout your life. This anomaly refers to intrauterine pathologies, so all responsibility lies with the expectant mother. Some preventive rules will help reduce the risk of development:

Healthy lifestyle.
No contact with toxic substances during pregnancy.
Complete cessation of smoking and alcohol.
Regular ultrasound examination.
Balanced and fortified nutrition.
Hardening the body.
Avoid hypothermia.
Avoid contact with sick people.

By following simple rules, you can reduce the risk of developing congenital anomalies of the urinary system and carry and give birth to a healthy child.

Currently, incomplete doubling of the kidney is considered the most common form of pathological development of the organs of the urinary system. This disease, in fact, is not considered a disease and does not have its own symptoms, but it reveals a high tendency of the patient to damage the kidneys with chronic nephropathies.

With the development of incomplete doubling, there may be two options for the course of the pathology:

The kidney receives its nutrition from one artery and has two pelvises.
It has only one pelvis, but at the same time two arteries that exit the aorta separately.

Reasons for the development of incomplete duplication

Incomplete duplication of the left or right kidney develops due to the formation of two infectious foci at once in the metanephrogenic blastema. Complete separation of the blastema does not occur, even despite the appearance of two pyelocaliceal systems at once - this occurs due to the preservation of the capsular covering of the organ.

Each half of the pathological organ has its own blood supply. The vessels of this organ can exit in a common column - so the division is formed nearby, not far from or at the sinus itself, or they can extend directly from the aorta. Some arteries located inside are capable of passing from one kidney to another - this is very important to consider when performing organ resection.

Partial doubling is a type of organ doubling, which is characterized by the peculiarity of the structure and structure of the organ, when the doubling of blood vessels and renal parenchyma is carried out without bifurcation of the pelvis. It turns out that the renal sinus is divided by a bridge of parenchyma into two separate sections. Such division provokes an increase in the size of the organ.

It is important! As a rule, incomplete organ duplication is not at all dangerous and does not imply any clinical conclusion, unlike the development of full duplication. The only danger in this situation is the option in which the pyelocaliceal system, as well as the ureters, doubles. To make a correct diagnosis, it is necessary to perform an excretory test.

Clinical picture of the pathology

Incomplete doubling of both kidneys or one of them is manifested by doubling of the renal vessels and parenchyma, but is not accompanied by doubling of the pelvis. Usually the upper part of the affected organ is smaller than the lower part.

Usually, two ureters of the double kidney open at once with holes directly into the bladder; occasionally the ureter splits, which has one opening in the pelvic region and one trunk; in its upper part it splits and unites with the pelvis. The ureters are capable of splitting at various levels. If there are two ureteric openings on one side of the bladder, then the opening of the ureter of the pelvis located above is adjacent to the opening of the lower pelvis. Often the ureters intertwine along their path, usually once or twice.

At the site of the union of the two ureters, a narrowing is formed, which, at the site of their complete fusion, interferes with normal urodynamics, even if the anatomical patency of this section is maintained. The upper part of the right or left kidney is mainly affected, which slows down the continuous flow of fluid, and therefore contributes to the development of hydronephrosis of the kidney and the formation of a chronic inflammation process. If a pathological process does not develop in the double kidney, then no clinical symptoms are observed. In this regard, the disease is more often diagnosed by chance.

Symptoms of the development of pathology

Signs of incomplete duplication of the left or right kidney in children mainly consist of infection of the urinary canals - this process is considered an indication for a comprehensive examination.

A person diagnosed with incomplete duplication of the kidney can live a long life without complaints or health problems, and the pathology is detected by chance during an ultrasound examination. Duplication affecting the ureters is more often the cause of vesicoureteral reflux due to inadequate functioning of the closing functions of the orifices. Reflux usually occurs in the lower part of the bifurcated kidney. The mouth of the ureter in the upper part of the organ narrows, and this provokes the formation of a cyst, which flows into the lumen of the bladder and causes expansion of the ureter.

Diagnostic measures. Varieties and implementation

Typically, incomplete kidney duplication does not require special diagnostics. In this case, complete doubling is detected after the development of the inflammation process begins. Any doubling can be easily detected by x-ray or ultrasound.

The diagnosis of the lesion is established based on the results obtained after cystoscopy, excretory urography, and ultrasound. makes it possible to examine the work of each part of the double kidney, its anatomical and structural changes. Ultrasound and computed tomography play an important role in the diagnostic process.

It is important! When there are pronounced changes in one of the halves of the kidney and deterioration of its functions, retrograde pyelography is used.

Clinical studies indicate a high incidence of various pathologies on the side opposite to the side of the kidney duplication. When both kidneys are doubled at once, acquired or congenital pathology is often diagnosed - dysplasia, hydronephrosis, etc.

The need and organization of treatment for incomplete duplication

Treatment of the disease primarily involves treatment of an acquired infectious process or pathology, such as urolithiasis or pyelonephritis. Incomplete doubling in itself is not a disease, but this pathology significantly increases the risk of developing an inflammation process. If the damage to the double kidney becomes chronic and difficult to treat, the doctor prescribes resection for the patient.

It is important to know that when identifying incomplete duplication of this organ in a person, it is recommended that he begin to adhere to a healthy lifestyle. It is imperative to prevent the influence of toxic factors on the body - for this you will need to give up drinking alcoholic beverages and smoking.

The doctor also reviews drug therapy, paying special attention to the diet. It is important to remember that the kidney will function properly until it becomes difficult due to poor nutrition and unfavorable living conditions.

It is imperative to organize events aimed at hardening the body, as well as gradually conduct physical training. In this way, a person can prevent many lesions and complications that are caused by kidney duplication. A specialist can help you form the right diet and lifestyle.

March 17, 2017 Doctor

Double kidney is the most common type of urinary tract anomaly. Such an anomaly is not a pathology; as a rule, its presence does not cause a person any particular inconvenience, but the doubling of an organ is dangerous with the risk of developing other more serious diseases.

According to external characteristics, the pathology represents two internal organs fused together. In this case, the duplication of the vascular and parenchymal parts does not always occur; most often, its lower part is functional. Duplication can be unilateral or bilateral, complete or incomplete - all this is a conditional division, which is associated with the presence of its own vessels, as well as the ureter in the daughter kidney.

With complete doubling of the internal organ, each of the daughter kidneys is equipped with its own pyelocaliceal system, as well as a ureter, which opens the way to the bladder. When incomplete, the ureters merge into one, which opens a “passage” to the bladder. It often happens that the daughter ureter does not merge with the main one, but it opens in the intestine or vagina. If the latter anomaly occurs, then the person will be found to have urine leakage.

Causes

Most often, the anomaly develops in the prenatal period, when the embryo is actively developing inside the mother. Medical statistics indicate that girls are more susceptible to this anomaly, and out of 150 newborns, one of them is diagnosed with pathology. In most cases, duplication of only one kidney is observed (82%), but bilateral duplication also occurs (12%).

The main reasons may be:

Genetics;
Taking potent hormonal drugs by a pregnant woman (especially in the 1st trimester);
Exposure of a pregnant woman to ionizing radiation;
Lack of vital vitamin or mineral components in a woman’s body during pregnancy;
Avitaminosis;
Poisoning of the body with potent drugs;
Abuse of alcoholic beverages;
Smoking during pregnancy.

Incomplete kidney duplication does not pose a particular threat to humans. It even happens that a person lives his whole life with a congenital anomaly and is completely unaware of its presence, and it is discovered only during a medical examination of a completely different disease.

Complete doubling of the kidney is dangerous due to its possible complications, among which we can highlight:

Pyelonephritis is an inflammatory process of the urinary tract with damage to the pelvis, cups and renal parenchyma;
Hydronephrosis is a violation of the process of urine outflow, in which urine is retained and accumulates in the renal pelvis;
Urolithiasis is the process of formation of sand and stones in the organs of the urinary system;
Tuberculosis;
Kidney neoplasm;

Types of kidney duplication

As mentioned above, the anomaly can be complete or incomplete.

Complete - instead of one internal organ, two are formed, each of which has an underdeveloped pelvis. Each of the pelvis is equipped with its own ureter, which flows into the bladder at a different level.
Incomplete doubling of an internal organ - in medical practice, this anomaly is more common than the one described above. The anomaly can appear on both the left and right kidneys, while an enlargement of the internal organ is clearly observed, its upper and lower parts are clearly visible, each of which is equipped with its own artery. During the development of the anomaly, the pyelocaliceal system continues to remain unified.

In addition, the anomaly can appear on either the left or right kidney.

On the left kidney - it does not pose a serious danger to humans, the anomaly does not have negative symptoms and is often discovered during a random medical examination;
On the right kidney, the anomaly also does not pose a serious threat to humans; during the process of formation, the internal organ takes on an increased size.

Symptoms

It is important to note that the characteristic signs of the anomaly appear only with complete doubling of the internal organ and appear in the form of:

Dilatations of the upper urinary tract;
The occurrence of infections in the urinary canal;
The appearance of the process of reverse outflow of urine from the ureter;
Manifestations of pain in the lumbar region from the side where the anomaly occurs;
Increased body temperature;
General weakness;
The appearance of a cloudy shade in the urine;
Increased blood pressure;
Painful process of urination;
Urinary incontinence.

These signs can appear both together and separately. The activity of symptoms directly depends on the form of the disease and the general condition of the human body.

Diagnostics

In order to clinically determine the duplication of the kidneys on both sides, the patient must undergo the following examinations:

Cystoscopy;
Ascending urography;
Radiography;
Magnetic resonance urography.

Treatment

An anomaly of both kidneys does not pose a serious danger to a person, but it can be accompanied by unpleasant complications, which is why it is necessary to recognize the disease in a timely manner and, if necessary, begin the required treatment.

If the anomaly does not bother a person, then drug therapy is not required. In this case, constant monitoring by a doctor is important. Treatment of internal organ duplication must be carried out if complications occur.

When an inflammatory process occurs, a course of taking anti-inflammatory drugs, as well as antibacterial agents, is indicated;
For urolithiasis, antispasmodics, painkillers and phototherapy (kidney collection, decoctions of medicinal herbs) are prescribed.

Surgery is indicated in severe stages of hydronephrosis, as well as in the presence of diseases that are not amenable to drug therapy. If possible, surgeons try to preserve the internal organ. A kidney is removed only if it loses its functionality.

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One way or another, when a double kidney is detected, a person must follow the most important basics that will help maintain his health and not provoke possible complications:

Lead a healthy lifestyle;
To refuse from bad habits;
Monitor the quality of food;
Be more careful and careful when taking certain medications;
Do hardening;
Do light exercise.

To summarize all of the above, it can be determined that kidney duplication is not a pathology; such an abnormal condition does not pose a threat to human health. A common question among young people is whether they are accepted into the army with this diagnosis? In answering this problem, it is necessary to determine that kidney duplication, not complicated by the presence of another pathology, is not an obstacle to enrollment in the ranks of conscripts.

But if the pathology is diagnosed in a woman, then she needs to plan her pregnancy in advance. Throughout the entire pregnancy, she must be observed by a doctor, regularly undergo prescribed examinations - urine and blood tests, ultrasound of the kidneys, urine testing according to Nichiporenko. Pregnancy is strictly contraindicated in women with renal failure and in the presence of clear indications for surgery.

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Kidney duplication, what is it, how does the disease manifest itself, what treatment methods does modern nephrology offer and how to prevent the development of an anomaly? All parents who are planning a pregnancy or are already pregnant should know the answers to these questions.

Having information about what double kidneys are, it is important to know what are the causes of the anomaly?

maternal ionizing radiation in the first trimester of pregnancy;
the use of potent drugs during the embryonic development of the fetus;
avitaminosis;
heredity;
alcohol abuse;
smoking.

There are other reasons that can disrupt the development of the fetus, provoke a violation of cell division, the structure of chromosomes, with the subsequent formation of kidney anomalies.

Types of anomaly

In pediatric nephrology, pathology is divided into two main types: complete or incomplete.

With complete doubling of the kidney, two lobules are present, while the renal pelvis of one lobe is underdeveloped. The pelvis has separate ureters that empty into the bladder. In some cases, there is an abnormal PFS, in which the ureter is discharged into the urethra. Despite the abnormal structure, the lobes of the organ can filter urine.

Symptoms of pathology

complaints of frequent headaches;
pain when urinating;
difficulty urinating;
increased weakness;
periodic increase in body temperature;
cloudy urine;
feeling of pain in the lower back.

Complications

The anomaly in which the organ doubles does not pose any threat to health, but still such children are at risk for developing diseases of the urinary system. It is known that with this anomaly, pyelonephritis develops in 30% of older patients. The risk of complications increases with the addition of a bacterial infection, which can lead to the manifestation of diseases such as:

To reduce the risk of complications, a child who has been diagnosed with this pathology should periodically visit a nephrologist, undergo an ultrasound examination, and undergo laboratory tests.

Diagnostics

If the development of an anomaly is suspected, the doctor prescribes a number of laboratory and instrumental studies that can be performed on both adults and children.

Urography.
Ultrasound of the kidneys.
Dopplerography.
Urine and blood analysis.
Cystoscopy.

Treatment methods

Antibiotics.
Anti-inflammatory drugs.
Uroseptics.
Immunoboosting medications.
Antispasmodics.

When drug treatment does not bring the desired results, inflammatory reactions in the tissues of the urinary system are repeated several times a year, the doctor recommends surgery.

Patients with a history of pathology are advised to adhere to proper nutrition, avoid heavy physical labor, and avoid hypothermia.

Prevention

Healthy lifestyle.
No contact with toxic substances during pregnancy.
Complete cessation of smoking and alcohol.
Regular ultrasound examination.
Balanced and fortified nutrition.
Hardening the body.
Avoid hypothermia.
Avoid contact with sick people.

By following simple rules, you can reduce the risk of developing congenital anomalies of the urinary system and carry and give birth to a healthy child.

Double kidneys are a congenital pathology, which in most cases is observed in girls and is often unilateral. The reasons for this phenomenon are very different. The duplication of the kidney begins to form and develop in the child while still in the womb.

Double kidneys. What it is?

The kidneys in the human body are a paired organ. They perform the function of removing toxins from the body. Everyone knows about this. But not everyone has heard that kidney doubling occurs. What it is? This is the division of an organ into two halves, fused together at the poles. Each part is equipped with its own blood supply system. Externally, such a kidney is much larger in size. The development of pathology occurs during intrauterine development.

Double kidneys in children are the most common congenital anomaly of the urinary system. An altered kidney does not pose a threat to human life, but is often the cause of other diseases.

The structure of the renal pelvis

This funnel-shaped structure is formed by the fusion of the major and minor calyces of the kidney. It is in the pelvis that urine accumulates. The surface of the inner part of the pelvis is covered with mucous membrane. In the wall of the pelvis there are fibers that perform peristaltic contractions, as a result of which urine flows down the urinary tract.

Due to the impermeability of the walls of the pelvis and ureters, the liquid with the substances dissolved in it never enters the peritoneal cavity, but always remains within the urinary system.

Complete kidney doubling

Sometimes a person is diagnosed with complete kidney duplication. What it is? This is an abnormal phenomenon when the kidney is divided into two parts by a groove. The upper and lower lobules are distinguished, and the upper one is most often underdeveloped and smaller in size. Each of them has its own artery and its own renal pelvis, which is usually underdeveloped in the upper half. They also have their own ureters. Each goes separately and ends in the bladder with its own mouth. It is possible that one ureter flows into another.

So, instead of one, there are two separate buds. In itself, complete doubling of the kidney does not bother a person, so there is no need to treat it. But it leads to other diseases.

Problems that arise when a kidney doubles

Often, some kind of disease may begin to develop in one half of the doubled organ. Complete doubling of the kidney can provoke pyelonephritis, urolithiasis, nephrosis, and polycystic disease. It happens that the mouth does not flow into the ureter, but into some other organ. It can be the rectum, cervix, vagina. In this case, a person may feel urine constantly leaking from the ureter.

Incomplete bud duplication

This pathology is observed when a person develops one large kidney with clearly defined upper and lower sections. Each of them has its own renal artery. N, each part of the doubled organ does not have its own pyelocaliceal system; they have one for two sections. There are two ureters, but they are connected to each other and flow into the bladder with a single trunk, like one.

In medical practice, cases have been recorded where incomplete doubling of the left kidney is more often observed, rather than the right. Most people with this anomaly live until old age, unaware of its existence. Incomplete doubling of the kidney does not cause inflammatory processes in the organ.

Causes of kidney duplication

If the pathology does not manifest itself in any way, which happens when a person has incomplete duplication of the left kidney or the right one, it doesn’t matter, you may not even know about the abnormal development of this organ. It is discovered by chance, during an ultrasound examination of some other organ located next to the kidney. Doctors often diagnose a double kidney in a newborn child. The reasons for this phenomenon can be very different. Let's look at some of them:

Radioactive exposure of the fetus in the womb, if her work activity during the entire period of pregnancy takes place at an enterprise whose production cycle is associated with radiation.
The predisposition is inherited if one or both parents have a double kidney. What it is is described above in this article.
Poisoning with drugs during pregnancy, including hormonal drugs.

Presence of bad habits in a pregnant woman: abuse of alcohol, drugs, etc.
Vitamin deficiency occurs frequently and regularly during pregnancy. There are many places on our planet where vegetables and fruits do not grow due to harsh climatic conditions. But women live and give birth to children there too. So the expectant mother suffers from a lack of vitamins and minerals. It’s good if everything works out and the child does not have a disease such as kidney duplication. Of course, there may be other reasons, but this one can be ruled out for the sake of the health of the unborn baby.

Diagnostics

If no examination was carried out when the person was a child, kidney duplication is diagnosed, as a rule, after an inflammatory disease of the organ begins or accidentally, during a preventive examination using diagnostic devices. First you need to do an ultrasound examination. If this is not enough, the doctor prescribes other methods.

When a person does not have pathology, there are only two ureteric orifices in his body: one for each kidney. If the doctor suspects kidney duplication, the patient is prescribed a cystoscopy. With its help, it is determined how many orifices the ureter has: if there are three, then the diagnosis of “double kidney” is confirmed. To determine the size of the enlarged kidney and identify the presence or absence of the third calyceal pelvis and additional ureter, the doctor prescribes excretory urography.

Kidney duplication does not manifest itself in any way. It does not need to be treated until it causes some other disease in this organ. Signs of kidney duplication vary. Typically, inflammatory processes are characterized by:

Increasing temperature.
Weakness and swelling.
Nausea and vomiting.
Regular headaches.
Increased pressure.
Cloudy urine.
Reverse flow of urine.
Discomfort and pain in the lumbar region.
Urinary incontinence.
Unpleasant sensations when urinating.
Renal colic.
The occurrence of infection in the urinary canal.

Whether all signs appear at once or each one separately will depend on the disease.

Kidney duplication is characterized by complete or incomplete division of the organ into two parts. If it doesn't bother the person, nothing needs to be done. It is enough to lead a healthy lifestyle and undergo regular preventive examinations. This pathology provokes inflammatory processes in the kidney when it completely doubles. Even in this case, there is no point in doing a complex operation to correct the defect. It may not cause trouble to a person throughout his life.

Therapeutic treatment is usually used when diagnosing some serious disease, for example, pyelonephritis, if it was caused by this anomaly. When the disease becomes chronic and cannot be treated using conservative methods, then they resort to surgical intervention, which is aimed at correcting the cause that caused the complication. But they always try to save the kidney. It is removed only when it has completely lost its functionality.

Prevention

If during the examination a doubling of the kidney is discovered, there is no need to panic. This diagnosis is not fatal. When the pathology of an organ does not bother you, it will not affect a person’s quality of life in any way. You need to take a closer look at your health:

Give up bad habits, if any: stop drinking, smoking, taking drugs.
Change your job if it involves toxic chemicals.
Urgently switch to a properly balanced diet.
Strictly monitor the work and rest schedule.

If one of your relatives has a doubling of the kidney, what it is is known to the whole family. Therefore, when a woman from your family is bearing a child, you need to treat this period with double attention. The child in the womb must develop, receiving the necessary vitamins. A woman is obliged to take care of her health and not take alcohol, drugs, or medications that can cause poisoning to the child.

With the development of incomplete doubling, there may be two options for the course of the pathology:

The kidney receives its nutrition from one artery and has two pelvises.
It has only one pelvis, but at the same time two arteries that exit the aorta separately.

Each half of the pathological organ has its own blood supply. The vessels of this organ can emerge in a common column - so the division is formed nearby, not far from or at the sinus itself, or they can extend directly from the aorta. Some arteries located inside are capable of passing from one kidney to another - this is very important to consider when performing organ resection.

It is important! As a rule, incomplete organ duplication is not at all dangerous and does not imply any clinical conclusion, unlike the development of full duplication. The only danger in this situation is the option in which the pyelocaliceal system, as well as the ureters, doubles. To make a correct diagnosis, excretory urography is required.

Signs of incomplete duplication of the left or right kidney in children mainly consist of infectious lesions of the urinary canals - this process is considered an indication for a comprehensive examination.

The diagnosis of the lesion is established based on the results obtained after cystoscopy, excretory urography, and ultrasound. Excretory urography makes it possible to examine the functioning of each part of the double kidney, its anatomical and structural changes. Ultrasound and computed tomography play an important role in the diagnostic process.

It is important! When there are pronounced changes in one of the halves of the kidney and deterioration of its functions, retrograde pyelography is used.

Clinical studies indicate a high incidence of various pathologies on the side opposite to the side of the kidney duplication. When both kidneys are doubled at once, an acquired or congenital pathology is often diagnosed - dysplasia, hydronephrosis, etc.

Treatment of the disease primarily involves treatment of an acquired infectious process or pathology, such as urolithiasis or pyelonephritis. Incomplete doubling in itself is not a disease, but this pathology significantly increases the risk of developing the inflammation process. If the damage to the double kidney becomes chronic and difficult to treat, the doctor prescribes resection for the patient.

Duplication of the kidney is one of the most common congenital anomalies of the structure of the urinary system, in which the altered kidney has the appearance of a doubled organ. They seem to be connected together, and each of them has its own parenchyma and blood supply through two renal arteries, and the more functionally significant and developed organ in most cases is the lower lobe of the formation.

In this article we will introduce you to the causes, signs, differences, methods of diagnosis and treatment of complete and incomplete kidney duplication. This information will help you get an idea of this malformation of the urinary system, and you will be able to ask your doctor any questions you may have.

When the kidney is bifurcated, the blood supply and parenchyma of the anomaly are always bifurcated, but the ureter and renal pelvis are not always doubled. The accessory ureter that occurs with this malformation can enter the bladder, connecting to the main one, or has an independent “gate” into the bladder cavity. This change in the structure of the urinary tract at the junction of the two ureters is accompanied by a narrowing, which causes difficulty in the outflow of urine and its reverse reflux into the pelvis. Subsequently, such functional disorders contribute to the development of hydronephrosis.

Kidney duplication can be complete or incomplete, unilateral or bilateral. According to statistics, the frequency of such a malformation of the urinary system is 10.4%. This renal anomaly is detected 2 times more often in girls and is usually unilateral (in approximately 82-89% of cases). In itself, it does not pose a threat to health, but its presence often contributes to the development of various kidney diseases.

Most often, this developmental anomaly is provoked by genetic causes and is detected in children at an early age. The defect can have various morphological configurations, and only a detailed diagnosis allows you to choose the right tactics for its treatment.

With incomplete duplication of the kidney, each of the ureters of the bifurcated organ does not flow into the bladder separately. They unite and enter the bladder cavity through a common duct. This type of kidney duplication is more common. Both the right and left kidneys may not double completely equally often. In this case, the following morphological structure of the changed organ is observed:

both daughter formations have a common capsule;
the pyelocaliceal system does not double, but functions as a single one;
bifurcation of the renal arteries occurs in the region of the renal sinus or these two arteries arise directly from the aorta;
each part of the duplicated kidney has its own blood supply.

In some cases, a person with an incompletely bifurcated kidney may not feel the anomaly present all his life, and the pathology is detected by chance during diagnosis for other diseases.

With complete doubling of the bud, two daughter formations are formed. Each of these organs has its own ureter and pyelocaliceal system. One of these kidneys may have an underdeveloped pelvis, and its ureter may not flow into the bladder at a physiological level.

With complete bifurcation of the kidney, each of the resulting organs is capable of filtering urine, but the resulting functional disorders often lead to the development of various diseases of the urinary organs:

hydronephrosis;
pyelonephritis;
urolithiasis disease;
nephroptosis;
tuberculosis;
kidney tumors.

Sometimes complete doubling of the kidney is accompanied by the appearance of an atypical morphological configuration, in which the ureter formed in the daughter kidney does not join together with the main one and does not flow into the bladder, but opens into the intestinal lumen or vagina. In such cases, the baby will leak urine from the rectum or vagina.

The main reason for the doubling of the kidney lies in the formation of two foci of induction of differentiation in the metanephrogenic blastoma. This disorder occurs during intrauterine development. Most often, such pathological changes occur due to the transmission of a mutated gene from parents or under the influence of teratogenic factors affecting the body of the pregnant woman and the fetus.

The following reasons affecting the body of the expectant mother can contribute to the doubling of the kidney:

ionizing radiation;
vitamin deficiency and mineral deficiency during pregnancy;
taking hormonal drugs during pregnancy;
viral and bacterial infections suffered during pregnancy;
poisoning with nephrotoxic drugs or toxic substances;
active and passive smoking, drinking alcohol during pregnancy.

In most cases, kidney duplication is completely asymptomatic for a long time or is detected by chance during routine examinations or during the diagnosis of other diseases.

Often pathology manifests itself only after its complications occur. One of the most common consequences of kidney duplication in children is urinary tract infection. In addition, narrowing of the ureters at their confluence can lead to circulatory problems, impaired urine outflow and reverse reflux. Subsequently, such changes can provoke the development of hydronephrosis.

With complete doubling of the kidney, the patient may experience the following symptoms:

signs of infection of the urinary organs (frequent urination, fever, pain and discomfort when urinating, pus in the urine, etc.);
swelling of the limbs;
pain in the lumbar region (from the side of the double kidney);
positive Pasternatsky symptom;
expansion of the upper parts of the urinary system;
reflux of urine from the ureters;
the appearance of renal colic (with the development of urolithiasis);
increased blood pressure;
leakage of urine (if the ureter enters the intestines or vagina).

The likelihood of occurrence of certain symptoms from the above-described signs of kidney duplication is variable and depends on the form of the anomaly.

A woman with a double kidney should plan to conceive a child in advance. To do this, she needs to undergo a full diagnostic examination: urine and blood tests, ultrasound and, if necessary, other instrumental studies. After analyzing the data obtained, the doctor will be able to determine the possibility of planning conception. Pregnancy with this pathology is contraindicated if renal failure is detected and there are indications for surgical treatment.

If during the examination no contraindications for conceiving a child are identified, then after pregnancy the woman should be observed by a general practitioner and a urologist. If any complications are detected, she will be indicated for hospitalization in the urology department for treatment of emerging complications. As clinical observations show, in most cases, kidney duplication in a pregnant woman rarely leads to severe complications. As a rule, doctors are only able to control blood pressure, eliminate swelling and other consequences of this anomaly using conservative treatment methods.

Kidney duplication in the fetus can be detected by ultrasound at 25 weeks of pregnancy.

Typically, signs of kidney duplication are detected by an ultrasound diagnostic doctor when examining a patient for pyelonephritis or urolithiasis. If such an anomaly is suspected, the patient is recommended to undergo the following additional studies:

radiography (overview image);
ascending and excretory urography;
radioisotope scanning;
cystoscopy.

In addition to instrumental examination methods, laboratory tests of blood and urine are prescribed.

If kidney duplication proceeds without complications, then the patient is recommended to undergo clinical observation by a urologist. He will need to undergo periodic kidney ultrasound and urine tests at least once a year. To prevent complications, the following doctor’s recommendations must be followed:

avoid hypothermia;
minimize the consumption of salty foods and foods rich in fatty acids;
observe the rules of personal and sexual hygiene to prevent infectious diseases.

Drug treatment for kidney duplication is prescribed to patients in whom this anomaly has led to the development of pyelonephritis, hydronephrosis or urolithiasis. The symptomatic treatment plan may include the following:

antibiotics;
antispasmodics;
painkillers;
anti-inflammatory and diuretic herbal teas;
following a diet to prevent urolithiasis.

Surgical treatment for kidney duplication is prescribed only in cases where the complications that arise cannot be eliminated with conservative therapy and lead to severe disruption of the functioning of the urinary system. The following conditions may be indications for its implementation:

urolithiasis that is not amenable to conservative therapy;
vesicoureteral reflux;
severe forms of hydronephrosis;
urethrocele (dilation of the urethra with the formation of a cavity).

In some cases, kidney duplication leads to the development of urolithiasis, the manifestations of which cannot be eliminated by therapeutic measures. If the stone very often bothers the patient, then instrumental or surgical techniques are used to remove it. Sometimes the removal of urinary stones can be carried out by crushing them with electromagnetic waves (by the method of remote lithotripsy). However, this method of breaking stones is not always possible. Some large stones can only be removed through surgery.

Ureteral stones can be removed after crushing through a cystoscope. If such an endoscopic procedure is ineffective, then removal of the stone is carried out after surgical opening of the bladder.

In severe forms of hydronephrosis and vesicoureteral reflux, the following types of interventions can be performed:

heminephrectomy or nephrectomy - removal of one or more segments of the kidney;
application of ureterouretero- or pyelopyeloanastomosis - creation of anastomoses to eliminate the reverse reflux of urine;
Tunnelization of the ureters is an antireflux intervention aimed at creating a lumen for the normal passage of urine.

Surgical operations are performed only if it is impossible to eliminate the consequences of hydronephrosis. In case of severe renal impairment, dialysis is recommended for the patient. If the kidney can no longer cope with urine filtration, the patient is prescribed a nephrectomy. Subsequently, the patient may undergo a kidney transplant from a donor.

If there is an abnormal flow of the ureter into the intestine or vagina, a corrective operation is performed to restore the normal flow of the ureter into the bladder cavity.

If a urethrocele occurs, the following types of operations can be performed to excise it:

ureterocystoneostomy – removal of the urethrocele and creation of a new ureteral orifice;
Transurethral dissection is an endoscopic operation to remove a urethrocele.

The purpose of such interventions is aimed at suturing the ureter into the intact wall of the bladder.

If kidney duplication is detected, the patient is recommended to be monitored by a urologist. Ultrasound and urine tests will be performed to monitor the kidney abnormality. To clarify the clinical picture of the pathology in more detail, the following methods for studying the urinary system are prescribed:

excretory and ascending urography;
cystoscopy;
radioisotope scanning;
MRI, etc.

Incomplete and complete doubling of the kidney in many cases does not pose a health risk and is often detected by chance during a preventive ultrasound examination of the kidneys or during examination for other diseases. In the absence of any symptoms, such a defect does not require treatment and only requires clinical observation. In some cases, this anomaly of the urinary system leads to the development of complications: pyelonephritis, hydronephrosis, vesicoureteral reflux and urolithiasis. If such consequences of kidney pathology occur, the decision on the need for conservative or surgical treatment is determined by the doctor. As a rule, kidney duplication has a favorable prognosis and rarely requires surgery to remove and transplant the organ.

An ultrasound diagnostic doctor talks about kidney doubling:

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