MODERN APPROACHES TO THE CLINICAL COURSE, DIAGNOSIS, AND TREATMENT OF DUPLEX KIDNEY

Duplex kidney is one of the most common congenital anomalies of the kidney and urinary tract. Although many patients remain asymptomatic, the condition may be associated with recurrent urinary tract infection, hydronephrosis, vesicoureteral reflux, ureterocele, ectopic ureter, urinary incontinence, and progressive functional loss of the affected moiety. This article presents a structured narrative review of the current literature on the clinical course, diagnosis, and treatment of duplex kidney. Contemporary evidence shows that ultrasonography remains the initial imaging method, while voiding cystourethrography, renal scintigraphy, and magnetic resonance urography are essential in selected patients for clarifying reflux, obstruction, and differential renal function. Current management is increasingly individualized. Conservative follow-up is appropriate in uncomplicated asymptomatic patients, whereas intervention is indicated in the presence of obstruction, ectopic ureter, ureterocele, significant reflux, recurrent febrile infection, incontinence, or functional deterioration. Organ-preserving reconstructive procedures now play a central role in patients with viable renal tissue, while heminephrectomy remains justified for nonfunctioning symptomatic moieties. The modern approach therefore combines precise anatomical and functional assessment with selection of the least traumatic treatment capable of preserving long-term renal function and quality of life.