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This video shows Horseshoe-shaped kidneys. A horseshoe kidney is formed by fusion across the midline of two distinct functioning kidneys, one on each side of the midline. They are connected by an isthmus of either functioning renal parenchyma or fibrous tissue. In the vast majority of cases, the fusion is between the lower poles (90%). Horseshoe kidney is probably the most common fusion anomaly of Kidney (midline fusion) or asymmetrical horseshoe kidney (L-shaped kidney). Ultrasonography is also helpful, but it may have some technical limitations. Horseshoe kidney is when the two kidneys join (fuse) together at the bottom. They form a U shape like a horseshoe. It is also called renal fusion. The condition occurs in a baby during intrauterine life, as the baby's kidneys move into place. Horseshoe kidneys can occur alone or with other disorders. Horseshoe kidneys are the most common type of renal fusion anomaly. The kidneys are susceptible to trauma and are an independent risk factor for the development of renal stones and transitional cell carcinoma of the renal pelvis. Horseshoe kidneys are mostly asymptomatic condition and are usually identified incidentally. These kidneys are however prone to a number of complications as a result of poor drainage, which may lead to clinical presentation. These complications include: Hydronephrosis, secondary to pelviureteric junction obstruction Renal calculi: up to 60% of patients Increased susceptibility to trauma Infection and pyeloureteritis cystica Increased incidence of malignancy Wilms tumor Transitional cell carcinoma (TCC) of the renal pelvis Renal carcinoid Renovascular hypertension There is an incidence of 1 in every 500 individuals within a normal population. Males are more likely to develop a horseshoe kidney with a preponderance of 2:1. Symptoms of horseshoe kidney flank (around the side, just above the waist) pain. Restlessness. Sweating. Nausea and/or vomiting. Blood in the urine. Changes in urinary frequency. Chills. Fever There isn't a cure for horseshoe kidney, but the symptoms can be treated if they cause problems (“supportive treatment”). Blockage of urine flow (“obstruction”) and urine flowing backward from the bladder (“vesicoureteral reflux”) are very common in patients with horseshoe kidney. These can both be fixed with surgery.