Horseshoe Kidney

What is a horseshoe kidney?

Horseshoe kidney occurs in about one in 500 children. It occurs during fetal development as the kidneys move into their normal position in the flank area (area around the side, just above the waist). With horseshoe kidney, however, as the kidneys of the fetus rise from the pelvic area, they fuse together at the lower end or base. By fusing, they form a "U" shape, which gives it the name "horseshoe."

One-third of individuals with horseshoe kidney will have at least one other anomaly or complication involving the cardiovascular system, the central nervous system, or the genitourinary system, such as the following:

  • Kidney stones. Crystals and proteins that form stones in the kidney that may lead to a urinary tract obstruction.
  • Hydronephrosis. Enlargement of the kidneys that usually results from a urinary tract obstruction.
  • Wilms tumor. An embryonic tumor of the kidneys that usually occurs during early childhood.
  • Renal cancer, or polycystic kidney disease
  • Hydrocephaly and/or spina bifida
  • Various cardiovascular, gastrointestinal findings (for example, anorectal malformations or malrotated bowel), or skeletal problems (for example, cleft lip or palate, clubfoot, or polydactyly)

Horseshoe kidney can occur alone or in combination with other disorders.

Prevention & Risk Treatment

Prevention & Risk Treatment

What are the symptoms of horseshoe kidney?

About one-third of children will have no symptoms. One-third of individuals with horseshoe kidney will have another anomaly or other complication involving the cardiovascular, nervous, or genitourinary system. The symptoms of horseshoe kidney may resemble other conditions or medical problems. Always consult your child's doctor for a diagnosis.

Diagnosis

Diagnosis

How is horseshoe kidney diagnosed?

In a child without symptoms, diagnosis or treatment may not be necessary. If your child is having any of the mentioned complications, your child's doctor may order one or more of the following diagnostic tests:

  • Renal ultrasound. A diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.
  • Voiding cystourethrogram (VCUG). A specific X-ray that examines the urinary tract. A catheter (hollow tube) is placed in the urethra (tube that drains urine from the bladder to the outside of the body) and the bladder is filled with a liquid dye. X-ray images will be taken as the bladder fills and empties. The images will show if there is any reverse flow of urine into the ureters and kidneys.
  • Intravenous pyelogram (IVP). A diagnostic imaging technique that uses an X-ray to view the structures of the urinary tract. An intravenous contrast of dye is given so that the structures can be seen on film. An IVP also reveals the rate and path of urine flow through the urinary tract.
  • Blood tests. These determine how well the kidneys may be functioning.
  • Urine tests. These tests include a culture.
Children's Team

Children's Team

Providers

Departments

Departments

Urology

At Children’s National in Washington, DC, our pediatric urologists provide comprehensive care for disorders affecting reproductive and urinary organs.

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Craig Peters' Story

Craig Peters

Craig Peters, MD, is the chief of Surgical Technology and Translation and Principal Investigator in the bioengineering initiative at the Sheikh Zayed Institute for Pediatric Surgical Innovation.

Read More of Craig Peters' Story