Renal ectopia

Renal ectopia
ICD-10	Q63.2
ICD-9	753.3

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Renal ectopia or ectopic kidney describes a kidney that is not located in its usual position. It results from the kidney failing to ascend from its origin in the true pelvis or from a superiorly ascended kidney located in the thorax.

Crossed-fused renal ectopia

• Crossed ectopy = kidney located on the opposite side of the midline from its ureter.
• In 90% of crossed ectopy, there is at least partial fusion of the kidneys (the remainder demonstrate two discrete kidneys on the same side, crossed-unfused ectopy)
• Due to improper renal ascent in embryogenesis (4^th-8^th week of fetal life - normally, the kidney reaches its appropriate position at L2 level at the end of the 2^nd month)
• Fusion of the kidneys within the pelvis leads to crossed-fused renal ectopia.
• Abnormally situated umbilical artery prevents normal cephalic migration. Another theory is that the ureteric bud crosses to the opposite side and induces nephron formation in the contralateral metanephric blastema.

=Epidemiology

• Incidence: 1 out of 1,000 births.
• 2:1 male to female ratio
• A single renal mass with two collecting systems is located on one side of the abdomen.
• Left-to-right ectopy three times more common.