Horseshoe Kidney

What is a horseshoe kidney?

Horseshoe kidney is a condition that is present at birth. It occurs during fetal development as the kidneys move into place. With this condition, the 2 kidneys join (fuse) together at the bottom to form a U shape or horseshoe shape.

In many cases there are no symptoms. But about 30% of people with horseshoe kidney will have at least 1 other problem or complication involving the cardiovascular system, the central nervous system, or the genitourinary system. These problems may include the following:

  • Kidney stones. This is a condition in which crystals and proteins that form stones in the kidney that may lead to a urinary tract obstruction.

  • Hydronephrosis. This is enlargement of the kidneys. It usually results from a urinary tract obstruction.

  • Wilms tumor. This embryonic tumor of the kidneys usually occurs during early childhood.

  • Kidney cancer or polycystic kidney disease

  • Hydrocephaly and/or spina bifida

  • Various cardiovascular, gastrointestinal, or skeletal problems

Horseshoe kidney can occur alone or with other disorders.

What are the symptoms of horseshoe kidney?

About 30% of children will have no symptoms. About another 30% of children with horseshoe kidney will have another problem involving the cardiovascular, nervous, or genitourinary system. The symptoms of horseshoe kidney may look like other conditions or medical problems. Always check with your child's healthcare provider for a diagnosis.

How is horseshoe kidney diagnosed?

A child with no symptoms may not need diagnosis or treatment. If your child is having complications, your child's healthcare provider may order 1 or more of the following tests:

  • Kidney 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 check blood flow through various vessels.

  • Voiding cystourethrogram (VCUG). A specific X-ray that examines the urinary tract. A hollow tube (catheter) is placed in the tube that drains urine from the bladder to the outside of the body (the urethra). 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 test 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 check how well the kidneys may be working.

  • Urine tests. These tests include a culture.

What is the treatment for horseshoe kidney?

A child without symptoms may not need any treatment. If your child has complications, his or her symptoms will be treated. But there is no cure for the condition.

  • Your child’s healthcare provider will figure out the best treatment plan based on:

  • Your child’s age, overall health, and medical history

  • How sick your child is

  • How well your child handles certain medicines, treatments, or therapies

  • If your child’s condition is expected to get worse

  • The opinion of the healthcare providers involved in your child's care

  • Your opinion and preference

Your child may be referred to an expert in disorders and care of the urinary tract and the male genital tract (a urologist) for evaluation. Or your child may be referred to an expert in disorders or diseases of the kidney (a nephrologist).