Horseshoe Kidney

What is 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 of the body, just above the waist). With a horseshoe kidney, however, as the kidneys of the fetus rise from the pelvic area, they fuse together at the lower end or base and usually lay positioned lower in the abdomen than normal. By fusing, they form a “U” shape, which gives it the name “horseshoe.” Horseshoe kidney can occur alone or in combination with other disorders. About one-third of children will have no symptoms. A horseshoe kidney typically does not affect life expectancy.

What are the symptoms of horseshoe kidney?

Horseshoe kidney can occur alone or in combination with other disorders. About one-third of children will have no symptoms. A horseshoe kidney typically does not affect life expectancy. One-third of individuals with horseshoe kidney will have another anomaly or other complication involving the cardiovascular, nervous, or genitourinary system.

  • Kidney stones
    A kidney stone is a hard mass that develops when chemicals in the urine crystallize or form into a mass within the kidney. Increasing water intake can help reduce the chances of developing stones.
  • Hydronephrosis
    Swelling of a kidney due to urine backup due to a blockage of the ureter. This is diagnosed using an ultrasound.
  • Wilms tumor
    An embryonic tumor of the kidneys that usually occurs during early childhood.
  • Vesicoureteraul Reflux
    Also known as VUR, this is typically noticed after a urinary tract infection that also comes with a fever.
  • Renal cancer
    Cancer that forms in the lining of very small tubes in the kidney that filter the blood and remove waste products or forms in the center of the kidney where urine collects.
  • Various cardiovascular, gastrointestinal findings (e.g., anorectal malformations, malrotated bowel)
  • Skeletal problems (e.g., cleft lip/palate, clubfoot, polydactyly)

The symptoms of horseshoe kidney may resemble other conditions or medical problems. Always consult your child’s doctor for a diagnosis.

How is horseshoe kidney diagnosed?

Horseshoe kidney will often be found on prenatal ultrasounds. In a child without symptoms, diagnosis or treatment may not be necessary. If the child is having other complications, one of our specialists may order a renal ultrasound. This diagnostic imaging technique 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.

What are the treatments?

In a child without symptoms, treatment may not be necessary. If your child has complications, he or she may require supportive treatment, which means his or her symptoms will be treated.

Specific treatment will be determined by the child’s doctor based on:

  • The child’s age, overall health, and medical history
  • The extent of the disorder
  • The child’s tolerance for specific medications, procedures or therapies
  • Expectations for the course of the disorder
  • The family’s opinion or preference

Most children may need ultrasounds to help monitor the kidney, especially if they have another urinary tract condition such as hydronephrosis or VUR. Most children will not need to have continual treatment.