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Associated anomalies and clinical outcome in children with ectopic kidney
Cagla Serpil Dogan1, Mustafa Erman Dorterler2, Mustafa Devran Aybar3
1Division of Pediatric Nephrology, Sanliurfa Children's Hospital, Sanliurfa, Turkey.
Insights
Children with renal ectopia (RE) often have associated urinary anomalies, most commonly vesicoureteral reflux (VUR). Early detection and monitoring are crucial for managing renal outcomes in these pediatric patients.
Area of Science:
- Pediatric Urology
- Nephrology
- Congenital Anomalies
Background:
- Renal ectopia (RE) in children can be associated with significant urological anomalies.
- These anomalies may lead to impaired renal function, necessitating further investigation.
Purpose of the Study:
- To evaluate the spectrum of associated urological anomalies in children diagnosed with renal ectopia.
- To assess the renal outcomes in pediatric patients with renal ectopia.
Main Methods:
- Retrospective study of 68 children diagnosed with renal ectopia between January 2009 and May 2014.
- Analysis of patient demographics, type of renal ectopia (simple vs. crossed), associated anomalies, and renal function.
- Voiding cystourethrogram (VCUG) utilized to identify vesicoureteral reflux (VUR).
Main Results:
- Vesicoureteral reflux (VUR) was identified in 28.6% of simple RE cases but not in crossed RE.
- Pelviureteric junction obstruction and neurogenic bladder were observed in a small subset of patients.
- Renal impairment was more common in patients with additional urinary anomalies.
Conclusions:
- Children with renal ectopia frequently present with associated urological anomalies, with VUR being the most prevalent.
- Comprehensive urological investigation and regular follow-up are essential for managing pediatric patients with renal ectopia.
Abstract:
Urological anomalies can be seen in children with renal ectopia (RE) and can result in renal impairment. Therefore, we evaluated associated anomalies and renal outcome in our patients with RE. Sixty-eight children who were diagnosed with RE between January 2009-May 2014 were retrospectively studied. A total of 68 patients, 36 (52.9%) boys, with a median age of 67 months (4-201) and a median follow-up period of 14 months (3-113) were included in the study. Simple RE (S-RE) was found in 51 (75%) patients, of which 46 were unilateral and five were bilateral (discoid kidney). Crossed RE (C-RE) was detected in 17 (25%) patients. Voiding cystourethrogram was performed in 21/51 (41.2%) patients in S-RE group and 5/17 (29.4%) in C-RE group. We did not find vesicoureteral reflux (VUR) in any of the patients with C-RE, whereas, in S-RE group, VUR was demonstrated in six (6/21 - 28.6%) patients. Pelviureteric junction obstruction in ectopic kidney was found in two patients with S-RE and one with C-RE. Two patients (2/17 - 11.7%) had neurogenic bladder due to meningomyelocele, accompanied by imperforate anus in C-RE group. There were no significant differences in other associated urological anomalies between two groups. Renal impairment developed mostly in patients with additional urinary anomaly. The children with RE may have associated urinary anomalies, of which VUR is the most common. Complete urological investigation and regular follow-up are required in selected cases.
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