Children - Horseshoe Kidney

What is a horseshoe kidney?

Horseshoe kidney occurs in about 1 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 people with horseshoe kidney will have at least one other problem or complication involving the cardiovascular system, the central nervous system, or the genitourinary system, such as 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 in combination with other disorders.

What are the symptoms of horseshoe kidney?

About one-third of children will have no symptoms. One-third of children with horseshoe kidney will have another problem complication 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 doctor 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 doctor may order one 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 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 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 checks how well the kidneys may be functioning.

  • Urine tests. These tests include a culture.


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 health care provider will figure out the best treatment based on:

  • How old your child is

  • His or her overall health and medical history

  • How sick he or she is

  • How well your child can handle specific medications, procedures, or therapies

  • How long the condition is expected to last

  • Your opinion or preference

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

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