What is incomplete kidney duplication: clinical manifestations and treatment. Incomplete kidney duplication

One of the most common anomalies in the development of organs of the urinary system is a double kidney. This anomaly is always congenital and forms in the first trimester of pregnancy, during active organogenesis. There are so many factors predisposing to this anomaly that it is not possible to single out any main one. Anomalies associated with the development and functioning of the kidney can be different, so urologists distinguish between duplication or the presence of an additional kidney.

What is doubling?

The term doubling usually means the presence of a kidney that is much larger than the volume and size of a normal kidney, which is associated with improper formation of the urinary system during intrauterine development. When doubling on the part of the abnormal kidney, a significant increase in its lower pole can be distinguished. This is where the additional part is located. A condition in which the lower pole of an abnormal kidney is much larger than normal is called incomplete kidney duplication.

Doubling most often occurs in females, and it is not always possible to suspect this anomaly in a newborn, since the peculiarities of the functioning and development of many organs and systems do not allow assessing the entire clinical picture.

Often, a double kidney does not bother a person at all, who can live his whole life with it without learning about the pathology. However, in some cases, a double kidney may be a factor in the development of diseases of the urinary system.

This photo shows the main shapes

Incomplete doubling

Incomplete or partial doubling is most often detected on the left side; an explanation for this fact has not yet been found in medicine, but the fact remains a fact. IN in rare cases doubling occurs on both sides. Incomplete doubling of the left kidney differs from complete doubling in that in this case the ureters from the regular and accessory kidneys merge into a single one and flow into the bladder together. With incomplete doubling, each of its parts is supplied with blood by its own renal artery, however, the pyelocaliceal system remains unified.

Full doubling

With complete duplication, complete anatomical division occurs collecting system anomalous kidney, but the parenchyma of the organ remains partially connected and their capsule is single. Complete duplication of the right kidney is somewhat more common than the left one.

Causes of abnormalities of the urinary system

The reasons for kidney duplication are very diverse; as mentioned above, abnormal development of the urinary system occurs under the influence of large quantity various factors like external environment, as well as the characteristics of the functioning of the mother’s body during pregnancy. The nature of the anomaly is multifactorial and the main components of the incorrect formation of the abdominal system are:

• impact on the mother's body various types ionizing radiation even in the smallest doses;
• lack of vitamins, macro- and microelements in particular folic acid, magnesium and selenium;
• application medicines with the presence of a teratogenic effect on the body of a pregnant woman;
• Availability bad habits related to the use tobacco products and alcoholic beverages, is dangerous not only for the mother, but also for the child.

There are also a dozen more factors that contribute to the activation of genetic errors and significantly affect pregnancy. It is worth noting that the maternal body and the developing fetus are most sensitive to all factors during the first trimester, when tissue differentiation occurs and the formation of the main organs and systems occurs; it is at this moment that the most unpleasant consequences for a child.

Timely and thorough pregnancy planning is the key to children’s health

Signs

The double organ does not cause any specific symptoms. Incomplete doubling may be completely asymptomatic and detected only with preventive diagnostic examination. Sometimes it happens that a person lives with an abnormal kidney, when it is double, all his life, without ever learning about the peculiarities of the functioning of his own body. But with complete doubling, the picture is completely different; often, over time, urodynamic disturbances begin to form in the pyelocaliceal system of one of the organs, which leads to the formation of pathological processes.

Due to disturbances in urodynamics in the abnormal kidney, the most a common complication is the development of the inflammatory process in the pyelocaliceal system. Less commonly, reflux occurs, i.e., the reverse flow of urine from the ureters, which leads to the development of hydronephrosis and urolithiasis.

The most common symptom which a patient with an anomaly experiences is pain syndrome. The pain is localized in the lower back and is aching character, which is associated with inflammation and subsequent swelling. In addition to pain, there may be general weakness, swelling and fever.

How to detect doubling

Doubling is rarely detected in a newborn, and even more so in a fetus, since the structure of their organs is still immature. Kidney duplication in a child can be detected starting from 8-9 years of age, when the organ systems are already fully formed and correspond to an adult body. Almost always, doubling becomes an unexpected finding during a diagnostic study, sometimes not at all related to the urinary system. The most informative research methods are ultrasound diagnostics And CT scan. These research methods make it possible to confirm the anomaly with 100% probability and determine complete or incomplete organ duplication.

To clarify the diagnosis, a patient with such an anomaly can undergo ascending urography and cystoscopy. Directly during a cystoscopic examination, the urologist can determine the orifice of the ureters, which will confirm the complete separation of the two kidneys.

Pregnancy and doubling

If a woman planning a pregnancy knows about her urinary system anomaly, she should approach pregnancy planning more responsibly. Doubling is not a contraindication to pregnancy, but in some cases pregnancy can provoke inflammatory diseases in an abnormal kidney.

It's no secret that during pregnancy, along with the growing child, the uterus also enlarges, which leads to compression and displacement of organs abdominal cavity, and since they are located in the retroperitoneal space and are fixed, they cannot normally move. Pregnancy can lead to compression of the abnormal kidney and disruption of its functioning. When planning a pregnancy with the presence double kidney a woman must undergo a thorough examination of the urinary system and follow all recommendations of the attending physician and obstetrician-gynecologist.

Kidney doubling and conscription into the army

Doubling does not exempt the conscript from mandatory military service , this means that conscript category “B” gives him the right to serve in troops with limited physical activity. With a double kidney, they are taken into the army in such troops as communications and engineering, which do not require serious stress on the body. In some cases, the diagnosis of a double kidney may exempt you from compulsory service, but this requires significant complications from the abnormal kidney, so chronic pyelonephritis a conscript may be issued a military ID of category “B”.

Treatment of a double kidney

In the absence of any significant symptoms and the clinical picture of complications with an abnormal kidney, you can live without exposure this state no correction. With incomplete doubling, the risk of complications is minimal and such a patient can live a calm and full life without treatment. If during diagnostic study Serious morphofunctional changes in the pyelocaliceal system have been identified, then this condition becomes a reason for specialized treatment.

Treatment consists of prescribing the patient a planned surgical intervention - heminephrectomy. During heminephrectomy, a retroperitoneal access to the abnormal kidney is formed and the most altered part of the kidney is excised, followed by suturing of the surgical wounds.

When the abnormal part of the organ is removed, urodynamics in the kidney are normalized and the clinical picture of any complications gradually disappears. It is very important to follow all recommendations of the surgeon and the attending physician in postoperative period, since the kidney is a very delicate organ and rehabilitation takes quite a long time. Correction of diet and drinking regime allows you to speed up the recovery stage and quickly move on to a full life.

Double kidney - congenital anomaly development. Normally, a person has two kidneys - one on the left, the other on the right side. In case of fetal development disorders, they can double in one or two lobes, or form as a third or even fourth kidney (with a complete bilateral defect). Girls are more susceptible to this feature; in boys, the anomaly is much less common.

According to statistics, the mutation occurs in one newborn child out of 150. As a rule, kidney duplication does not pose a threat to life; in most cases, the patient learns about the defect by chance, for example, during an examination. However, in some cases doubling can contribute to the appearance secondary diseases urinary system and require treatment.

Kinds

Many people get scared when faced with a diagnosis of “double kidneys” in themselves or their loved ones, and try to understand what it is and how much this condition poses a threat to life and health.

Most often (in 80% of cases) incomplete doubling of the left or right kidney is observed. In this case, the division of the organ does not occur; its enlargement and a bridge in the sinus area are observed, dividing the kidney into two sections that have a single pyelocaliceal system (PPS). Each lobule is fed by separate arteries. Visually Bottom part the double bud is larger than the upper one.

Sometimes the kidney is formed in both sections, but the vascular system of such a kidney is common. With incomplete duplication, the ureters depart from the pelvis and join into a common urinary stream.

Much less often (in 10% of cases) a diagnosis of “complete doubling of the kidney” is made. The left-sided anomaly is somewhat more common than the right-sided one. The development of a separate organ with its own pulse rate and blood flow is noted. Sometimes doubling the heart rate right kidney or left kidney leads to functional changes. In some cases, doubling of the pelvis is accompanied by underdevelopment of one of them. The ureter of a double kidney is separate, having its own opening in the bladder. Sometimes the ureter is not connected to bladder, and with the large intestine, and in females - with the vagina. In this case, urine exits through the corresponding organs, which requires surgical intervention.

Kidney duplication is one of the types of anomalies that are not a pathology. Often the diagnosis is made to adults who have not experienced problems with the urinary system throughout their lives.

Reasons for appearance

The defect occurs during intrauterine development. This can lead to:

1. Genetic factor (including hereditary). In families where the parents themselves or their close relatives have congenital features kidney structure, there is a high risk of having a child with the same defect.
2. Taking medications during pregnancy that have a teratogenic effect, leading to deformities and abnormalities in the fetus. It is necessary to be careful about all medications taken during this important period.
3. Exposure to ions, staying in places with increased radiation.
4. Insufficient intake of vitamins and minerals into the pregnant woman's body.
5. Drug addiction, smoking, drinking alcohol during pregnancy.

Symptoms

As a rule, partial doubling is not delivered special problems in life and is not accompanied by functional changes. Full doubling - more dangerous feature, it is often accompanied by an abnormal physiological structure and requires mandatory supervision by a specialist throughout life. The situation becomes more complicated if there is a doubling of the right kidney and the left one at the same time.

Often, the first signs of a special structure may appear during times of increased stress on the body, for example, during pregnancy in women, as well as during hypothermia or after lifting weights in men. In other cases, a structural anomaly due to vulnerability gradually leads to diseases of the urinary system and is accompanied by the following symptoms:

• disturbance of urination - urinary retention, pain and pain, weak stream;
• pain in the back of the lumbar region, which intensifies when tapping with the edge of the palm;
• urinary retention - dangerous condition, which may be accompanied by symptoms of intoxication - nausea, vomiting, weakness, unpleasant smell from the body;
• increase in body temperature from subfebrile (37º-37.5ºC) to high values;
• hypertension - arterial pressure above age norms;
• swelling (legs, body, face);
• sallow complexion.

These signs are accompanied by both diseases of the genitourinary system and disorders of functional abilities (for example, insufficient outflow of urine due to doubling and underdevelopment of the maxillary tract). If you have double kidneys, you should take care of your body and follow your doctor’s recommendations. In children, such symptoms can be acute and therefore require immediate hospitalization. Pregnant women should undergo regular monitoring of the condition of the baby's organs.

At incorrect structure kidney provoke primary diseases urinary system or exacerbation of old ones can:

1. Pregnancy.
2. Hormonal imbalance.
3. Wrong lifestyle: bad habits, disruption of sleep and rest patterns.
4. Hypothermia.
5. Hard physical work.
6. Sports activities involving heavy lifting or overload.
7. Abuse of medications that affect kidney function.
8. Insufficient consumption of clean water.
9. Urinary tract infections.

Diagnostic measures

Timely assessment of the condition and structure of organs with unilateral and bilateral defects makes it possible to identify deviations in functioning and, if necessary, prescribe therapy. If the anomaly does not affect the condition of the body, does not cause malfunctions in the urinary system (in case of incomplete doubling of the kidney), then the attending physician gives recommendations on lifestyle and diet and prescribes an annual examination. In other cases, medication and sometimes surgical treatment for kidney problems are recommended.

If a developmental defect is suspected, as well as during an annual doubling examination, the following set of diagnostic measures is prescribed:

• Ultrasound diagnostics with examination of the blood supply to the organ (Dopplerography). Modern equipment makes it possible not only to determine the location and structure of the kidneys, but also to evaluate their structure, as well as the slightest changes in it. Ultrasound with Dopplerography determines blood flow in the organ and assesses the condition of the blood vessels. The procedure requires preparation: drink 0.5 liters of water an hour - the bladder must be full, do not eat for 8 hours before the test, exclude it from the diet a day or two before flour products and bread, as well as sweets, raw vegetables, and milk. The fact is that some foods cause excess gas formation in the large intestine, which can distort the results of the study. An acceptable diet before an ultrasound of the abdominal organs is porridge, soups, boiled meat and fish. Young children and people suffering from flatulence are advised to take carminative medications before diagnosis. Children are recommended to drink water already in the ultrasound room, since due to physiological characteristics they have difficulty controlling the urge to urinate.
• X-ray with introduction contrast agent. Prescribed for pain, as well as for suspected kidney disease or chronic processes. Indispensable for complications - urolithiasis, the presence of tumors and others. The procedure is as follows: the patient is given intravenous injection(or drip infusion) with a contrast agent, then a series of x-rays, in order to identify the state of renal excretory function. Preparation for the study is the same as for an ultrasound.
• A modern and more informative method is computed tomography using a contrast agent. Thanks to it, the pictures are three-dimensional, clear, with their help you can see the condition of the kidneys, as well as the vessels that feed them. CT and X-rays are contraindicated in pregnant women to avoid disturbances in fetal development.
• Magnetic resonance imaging - gives an idea of ​​the structure of the organ, its functioning, the state of blood circulation, the presence of tumors, duplications, stones and other neoplasms. Today it is best method For deep research. Prescribed for controversial diagnoses or suspected complications. The procedure is quite long - about 40 minutes. During the study, the patient is placed in a special closed tube, so people with claustrophobia, as well as those suffering from diseases nervous system and psyche, MRI is not suitable. The procedure can be performed on pregnant women when indicated.
• Cystoscopy is an instrumental type of diagnosis. Involves introduction special catheter with a camera at the end into the urethra and bladder. Gives an idea of ​​the condition of the mucous membrane of these organs. It is carried out to clarify certain diagnoses - urolithiasis (UCD), tumors, cystitis and urethritis.

Treatment and prevention

Cure congenital structural features medicines impossible. Kidneys double during fetal development due to genetic failures or heredity, or due to external factors affecting the expectant mother.

Medicines are used to relieve pain for complications, as well as to eliminate infectious processes. For this purpose, painkillers and antibiotics are prescribed.

If there are stones in the organs of the urinary system, drugs are prescribed to dissolve or remove them.

If doubling leads to severe disorders that lead to a significant decrease in kidney function, then surgery is performed. They are as follows:

1. nephrectomy - removal of part of a kidney or organ completely;
2. antireflux surgery- plastic urinary tract, used for stagnation of urine;
3. connecting the ureters to the bladder by excision and creating a suture, as well as creating artificial septa. It is used when urine flows abnormally, for example, into the intestines, and also when urine is thrown back into the bladder.

To reduce the load on the organs of the urinary system, it is necessary to maintain healthy image life: exclude the use of alcohol and tobacco, professional sports, heavy lifting, hypothermia. To avoid infection in the genitourinary system, it is important to maintain hygiene sex life- protect yourself with unfamiliar partners using a condom, and if sexually transmitted diseases are detected, both partners undergo timely treatment.

The diet of patients with double kidney should not contain foods that irritate the mucous membranes. You should also avoid foods that retain fluid in the body. Therefore, for people with kidney abnormalities, before use following products It is worth consulting with a nephrologist:

• pickles and smoked meats;
• fast food, sausages, spicy dishes;
• sparkling mineral water.

To support the activity of the urinary system, you should drink 1.5-2 liters of water per day, drink in spring and autumn vitamin complexes(only after consulting a doctor, since some minerals included in the complexes are contraindicated for urolithiasis). Overload, both physical and psycho-emotional, should be avoided.

Kidney activity is extremely important for the entire body. At serious complications kidney diseases, the patient may die within a few days due to intoxication of the body. Therefore, it is important to diagnose organs in a timely manner and follow all the specialist’s instructions. This could ultimately save lives.

Double kidney is the most common form of anomaly in the development of the urinary system, which in itself does not pose a danger, but may be a predisposing factor for the development of certain diseases.

The doubling of the left kidney, like the right one, is a kidney supposedly divided into two parts, with each part of the abnormal kidney having its own blood supply. Usually the lower part of the double bud is more efficient. It is impossible not to notice that, unlike the parenchyma and the blood supply system, which double, like the organ itself, the ureter and pelvis remain intact and unified. This phenomenon is called incomplete kidney duplication.

Why does incomplete bud duplication occur?

Like most developmental anomalies, kidney duplication occurs:

• against the background of a hereditary factor,
• as well as under the influence of teratogenic factors on a woman during pregnancy, such as ionizing radiation,
• as well as vitamin deficiency, taking medications (mainly hormonal), exposure to chemical substances, smoking, alcohol abuse.

Incomplete duplication of the left kidney occurs with the same frequency as abnormal development of the right kidney. When the kidney doubles, the organ increases in size.

As a rule, incomplete duplication of the kidney is detected during ultrasound examination completely by chance and is perceived as an interesting find. A doubling kidney looks like an organ divided into two parts - the upper and lower section Yes, while each of their departments has a renal artery, but the pyelocaliceal system remains unified. Fortunately, the anomaly does not interfere to the usual way life, does not require treatment.

If there is incomplete doubling of the left kidney in combination with, we're talking about about bilateral doubling. Often this condition is combined with pathologies such as hydronephrosis and dysplasia.

Treatment and prevention of kidneys

Treatment for incomplete kidney duplication may be required only if the anomaly becomes a predisposing factor for the development of diseases - pyelonephritis, urolithiasis. If they purchase chronic nature, the doctor may decide to perform a resection.

If you have been diagnosed with “incomplete duplication of the kidney,” try to lead a healthy lifestyle - give up bad habits, play sports, review your diet, and toughen up. Do not take your diagnosis to heart - it is not fatal, and in most cases does not affect the quality of life. Just monitor your health in case of any alarming symptoms, tell your doctor promptly.

It is curious, but representatives of the fair sex are most susceptible to kidney doubling.

Today, cases of kidney duplication have become quite common.

This anomaly sometimes leads to serious diseases of the urinary system, and sometimes the patient may not even be aware of his pathology.

A little about the disease

Kidney duplication is a fairly common pathology of the urinary system, which is complete or partial organ duplication renal system. In this case, there are two connected kidneys, and each of them has its own blood supply.

Typically, such an anomaly develops during the period when the embryo is in the womb. Statistics report that for every 150 newborns there is one with a double kidney. Moreover, girls are twice as likely to be affected by this disease.

As a rule, doubling occurs only On the one side(82 – 89% of all cases), but there is also a situation bilateral doubling (11 – 12%).

Also distinguish complete And incomplete kidney doubling.

The altered organ does not pose a danger to the patient, but this pathology often promotes development serious illnesses kidney

How to determine the disease and why it may occur?

As already mentioned, kidney duplication is usually observed in newborns. Reasons Kidney duplications are usually:

• Genetic predisposition;
• Taking hormonal drugs by the expectant mother during pregnancy;
• Exposure to ionizing radiation;
• Vitamin deficiency during pregnancy, lack of some important minerals.
• Drug poisoning;
• The future mother's use of alcohol and cigarettes.

With incomplete doubling of the right or left kidney, a situation is usually observed when a person lives with a double kidney and does not suspect it, and the pathology is discovered by chance during an examination.

But full doubling ChLS of the kidneys often contributes to the development of diseases such as pyelonephritis ( inflammatory process kidneys, which is characterized by damage to the pelvis, parenchyma and calyces of the kidneys), hydronephrosis of one half of the kidney (a disease in which there is retention and accumulation of urine in the pelvis), urolithiasis disease(calculi, that is, stones, form in the organs of the urinary system), nephroptosis, tuberculosis, kidney tumor.

During complete doubling, the following appear: symptoms:

• Dilatation (expansion) upper paths urinary;
• The occurrence of infection in the urinary canal;
• Reverse flow of urine from the ureters;
• There may be pain in the lumbar region on the side where the pathology occurred;
• Turns out positive symptom Pasternatsky, that is, a symptom of renal effleurage;
• Weakness and swelling occur, the temperature rises;
• Renal colic may be felt;
• Blood pressure often rises;
• Painful sensations appear when urinating;
• Urinary incontinence may occur because one of the ureters does not enter the bladder.

These signs appear both together and separately - it all depends on the form of the disease.

What are the different types of kidney duplication?

As already noted, kidney doubling can be:

• Complete– instead of one kidney, two are formed, one of which has an underdeveloped pelvis. Each pelvis has its own ureter, which drains into the bladder at at different levels. Sometimes the lower part of one of the ureters has an anomaly in the form of an ending in a diverticulum Bladder, in the vagina or urethra (then the child experiences urine leakage, which can be regarded as incontinence);
• Incomplete doubling– occurs much more often, and can manifest itself both on the left and on the right kidney in children. In this case, an increase in the organ is observed, its upper and lower parts are clearly visible, each of which has its own renal artery. The pyelocaliceal system (PSS) remains unified. Sometimes it happens that two pelvises are formed, and the kidney is nourished by one artery.

Blood supply system in each half pathological organ its.

There are also situations when arteries from one part of the kidney go to another - this can significantly complicate the subsequent operation.

Measures for diagnosing and treating the disease

Diagnostics

Concerning diagnostics doubling the kidney, then the following methods are used for this:

Treatment

Treatment doubling is carried out in this way:

• Surgical methods are used in the development of diseases that impair the functioning of the kidneys and cannot be treated - hydronephrosis, urolithiasis, the occurrence of tumors. Also, in case of serious complications associated with the functioning of the damaged kidney, which pose a danger to the patient’s life, the kidney must be removed.
• If there is such a possibility, then the kidney is not completely removed, but partially - that is, heminephrectomy.
• Whenever renal failure held hemodialysis And kidney transplant from a donor.
• If the additional kidney does not affect the patient’s health in any way, conservative treatment and regular monitoring of the condition of the organ. To do this, about once a year the patient must have his urine tested and undergo an ultrasound of the renal system.
• Treatment is symptomatic. For inflammations prescribed antibiotics, with the formation of kidney stones - antispasmodics, analgesics, and herbal remedies like kidney tea, corn silk, etc.
• With the development of pyelonephritis, it is prescribed antibacterial drugs , with nephrolithiasis, the patient is immersed in warm bath, enter antispasmodics and appoint a special diet.

In any case, if kidney duplication is detected, the patient should begin to lead a healthy lifestyle, Give up bad habits, review with your doctor the list of medications he is taking, and balance your diet. Hardening the body is also useful, physical exercise. In this way, it is possible to help the abnormal kidney function normally and prevent the development of complications.

So, we can conclude that kidney doubling itself is not a disease, but just an anomaly that may not even make itself felt throughout life. But it is worth remembering that this anomaly also provides a prerequisite for the occurrence of other, more serious diseases if the altered organ is not treated with sufficient care. Remember that in this situation a lot depends on yourself and on your desire to maintain your health.

Video: What we need to know about kidneys

Had lesions of an inflammatory or other nature.

note

Often, such an anomaly does not in any way affect the child’s health and quality of life; many adults only learn about their similar anomaly in old age, without noticing problems with the child over the past years. genitourinary system. Such a deviation often has no effect on the functionality of the organ.

Kidney duplication in a child: definition of the concept

Regarding other malformations and anomalies, kidney duplication is the most common. According to statistics, girls with double kidneys predominate over boys, and unilateral lesions predominate over bilateral anomalies.

Modern doctors understand the term “double kidney” exclusively as a congenital defect. With it, partial or complete doubling of the organ is formed on one side (less often, bilateral).

On average, the prevalence of the anomaly is about 10% of all known defects urinary system children. It is noted in 1 case per 150 newborns, with unilateral defects accounting for up to 89%, and bilateral lesions accounting for the remaining 11%.

Visually, it looks like two fused kidneys, in the area of ​​one of their poles, and each of them has its own blood supply. An extra kidney is usually smaller in size than a normal one (although larger ones are possible). At the same time, the mere presence of an accessory kidney does not create serious physical defects and defective functioning of the urinary system. However, such an anomaly can be combined with other developmental defects or predispose to the development of certain diseases throughout life.

If the abnormal kidney is larger than normal, it may have additional vessels and an increased number of renal calyces or pelvises. In some children, the kidney is almost completely duplicated; a ureter emerges from each kidney, but one is somewhat less developed.

Is kidney duplication dangerous for a child?

With the development of ultrasound, a similar anomaly began to be detected in children, although it existed before. Many elderly people learn about the presence of such an anomaly after living full life without any problems. Therefore, such a defect does not bring any physical inconvenience or developmental delays, and doctors often only observe children, recommending that parents only complete care and nutrition control, prevention various lesions urinary tract. If any problems arise, medications may be prescribed according to the identified symptoms; surgical correction is required in exceptional cases.

Parents should not worry or panic about such a deviation; there are no special differences in the baby’s development, and it is only important to ensure that the kidneys are not overloaded and do not become inflamed.

What are the reasons for such a vice?

Like many other developmental defects, kidney problems arise in utero, during the formation of organs and systems, and there can be many obvious influences in each specific case, as well as accompanying ones. Doctors cannot name the exact reason, but there are a number of factors that increase the risk of having children with anomalies of the genitourinary system:

• Bad habits of parents and their impact on the fetus. This is especially true for the mother, but the effect on the father’s body is also important. , taking alcohol and psychotropic drugs affects the proper formation of tissues and organs, especially early stages pregnancy. In this regard, giving up such habits during the planning period eliminates at least some of the risk factors.
• toxic compounds that enter the body in different ways. This is especially important when working in hazardous industries, contact with chemicals and poisons in everyday life.
• high doses of radiation affecting fetal tissue. Particularly dangerous are CT scans or frequent radiography in early periods pregnancy. No less dangerous radiation treatment certain diseases shortly before pregnancy.
• taking medications that have a teratogenic and embryotoxic effect. Greatest danger Such drugs are given during the period of conception and up to 12 weeks of pregnancy. The decision to prescribe medications to pregnant women during this period is made only by the doctor, so as not to harm the fetus.
• sharp and pronounced deficiency of vitamins, mineral components, nutrients. This often happens when very poor nutrition women, fasting and diets, both therapeutic and weight loss.
• influence of heredity. There is often a connection between the presence of a double kidney in parents or close relatives and its detection in a child. If both parents have a similar anomaly, the chances of the child getting it increase significantly.

Features of the structure of a child’s double kidney

As a result of the impact of all unfavorable factors two areas of kidney growth may simultaneously form, from which two separate pyelocaliceal systems are gradually formed, but the kidneys are not finally separated from each other, due to which the double kidney will be covered with a common fibrous capsule. For each kidney, the vessels will be separate, they depart from the aorta, or there will be one common arterial trunk, then divided into two isolated parts, ultimately approaching each kidney separately.

In some cases, the arteries within a duplicate kidney can penetrate from one kidney to the other, which can then create complications if the abnormal extra kidney needs to be removed.

On ultrasound, the double kidney looks larger than usual, one part of it is more symmetrical and neat, while the second is more active functionally.

Important!

With an additional separate entrance of the second ureter into the bladder, health prognosis is better, this reduces risks various complications diseases.

Features of the classification of kidney duplication

Based on the degree of bifurcation of the kidney, several variants of pathology can be distinguished. Based on the degree of formation of the collecting system and kidney tissue:

• complete doubling of the kidney, when each organ has its own ureter, pyelocaliceal apparatus, but they are located parallel to one another and welded together. Both kidneys belong to separately functioning organs.
• incomplete (partial) doubling when only the kidney parenchyma and the area become doubled vascular system, while the pyelocalyceal system with the ureter is single.

Doubling is possible on the left or right; in extreme cases, doubling of both kidneys is possible.

A special variant of the defect is the doubling of the pyelocaliceal system with a single parenchyma and kidney capsule.

Kidney duplication in children: signs of a problem

Typical for the anomaly itself asymptomatic, but the developmental defect predisposes to the formation of more frequent illnesses the urinary system as a whole. Typically, symptoms occur with the development of secondary (against the background of existing duplication) kidney damage, but this does not happen in all children and not in all cases. Usually symptoms various pathologies are typical already for adulthood, sometimes old age.

If we talk about symptoms in general, you can expect:

• Inflammatory processes in the kidneys and urinary tract
• Impaired urination in the pelvis (urine retention in them)
• Urinary disorders different types, but usually without pain
• Loss of urinary control if the abnormal ureter of the duplicate kidney fuses with the urethra or vagina
• Development (salts in urine in children, small stones)
• Periods of development of swelling
• Episodes.

Often, all these symptoms are mild, appearing only periodically, with minor symptoms.

When an inflammatory process develops in the area of ​​a double kidney, the following may be typical:

• long-term painful nature
• Appetite disturbances, up to complete refusal from food
• Feverish reactions
• Problems with psycho-emotional development, memory and information reproduction.

When microbes spread to the area of ​​the bladder and urethra, symptoms or.

What complications are possible with doubling?

If this is a unilateral process, a double kidney rarely develops complications and is discovered by chance. If we are talking about bilateral damage, this condition is more dangerous. In addition, with incomplete doubling, the prognosis is also better than with complete duplication of the kidney. Children with doubling may more often experience pathologies such as:

• - an inflammatory process of microbial origin that involves inflammation of the pelvis and calyx of the kidney.
• Possible formation , urinary retention in the kidney area, which leads to atrophic phenomena.
• Predisposition to , when sand and small stones first form, which can block the ureters and lead to obstruction, which forms renal colic.
• , if pathogens penetrate through the blood or lymph flow and actively multiply in renal tissue. Such a pathology may not manifest itself in any way for a long time.
• Tumor processes in the accessory kidney, which is due to the fact that the kidney itself is an atypical formation for the body. Tumors also do not manifest themselves for a long time; malignant ones are more dangerous in terms of prognosis.
• Development vagal kidney becomes one of the complications due to the greater mobility of the abnormal double kidney. How stronger kidney goes down or shifts, the worse the forecasts.

By what methods is it determined?

Today, along with other countries, in our country, in the first year of life, it is used to determine the functioning of the kidneys, so developmental anomalies are detected quickly and early. After identifying kidney duplication, a decision is made on tactics further observation or treatment. Usually prescribed additional examinations in the form of radiography with contrast, or urography and duplex scanning renal vessels, to determine the renal vessels, is also shown.

It is equally important to carry out a number of tests that reflect the functioning of the kidneys and the presence of infection. These include smears from the urethral canal and urine biochemistry. As the baby grows and develops, he is given examinations to assess kidney function over time or control studies to determine the effectiveness of treatment measures.

Treatment methods for kidney duplication

If the kidneys are fully functioning and there are no secondary complications, there is no need for surgery or any other treatment. The child will undergo periodic preventive examinations with a doctor. You may only need to follow a diet that normalizes kidney function. It is important to exclude or reduce the amount of smoked, spicy and salty foods, sauces and marinades with salt and pepper, and fried foods in the diet. These foods and dishes significantly affect kidney function.

In case of secondary complications, the child is treated according to the pathology; the decision to operate to remove the accessory kidney is made only if it is affected by the pathological process.

Alena Paretskaya, pediatrician, medical columnist