Kidney Disease And Floating Kidney Nephroptosis

Your kidneys are important organs that filter blood and send waste products out of the body through the urinary system. Kidneys typically sit right below the rib cage on each side of your body, but some people experience nephroptosis or a floating kidney. Keep reading to learn more about floating kidneys and how doctors treat them. 

How are floating kidneys diagnosed?

Doctors typically diagnose floating kidneys after complaints of generalized abdominal pain, which leads to imaging tests at a medical facility. They are most easily diagnosed with imaging tests, and doctors may take images of your internal organs while you sit up and lie down.

A doctor will diagnose you with floating kidneys if they move by more than five centimeters.

You can also be diagnosed with a floating kidney if your doctor orders intravenous urography¹ while lying down and sitting up. Intravenous urography uses an x-ray and contrast dye to examine kidney function and check for kidney shape abnormalities. It can also see whether there is a kidney obstruction.

Many people with a floating kidney may not even know it. As it usually doesn't produce symptoms, it never gets diagnosed. 

Can a floating kidney cause problems?

Most floating kidneys don't produce any effects. In rare cases, some symptoms appear with a floating kidney, such as: 

• Nausea

• Hypertension

• Hematuria (blood in the urine)

• Proteinuria (protein in the urine)

Hypertension (high blood pressure) is a concern because it can damage the kidneys and other organs if you don’t receive prompt treatment. Many factors can cause hematuria, but they can indicate kidney damage or inflammation. Proteinuria often signifies kidney damage and can cause unpleasant symptoms like frequent urination, muscle cramps at night, foamy urine, and a lack of appetite. 

Another main complication of a floating kidney is Dietl’s crisis,² which occurs when the kidney blocks the ureter. The ureter is the tube that connects the kidney to the bladder, and obstruction can cause nausea, vomiting, and abdominal pain. Some people with a floating kidney may also be more likely to develop kidney stones and infections. 

Although most people with a floating kidney don't develop any symptoms, it can still be helpful to keep an eye out for any of the symptoms mentioned above in case you start developing complications. 

What causes floating kidneys?

Although there is no definitive cause of floating kidneys, scientists believe a fasciae deficiency is the cause. Perirenal fasciae are connective tissues surrounding and securing the kidneys. Researchers don’t know much more about the cause of floating kidneys, but they have speculated that it could be related to vigorous exercise, pregnancy, weight loss, and injuries. 

Prevalence of floating kidney

Floating kidneys are more common in women³ than men, and young women with smaller bodies often develop floating kidneys. Some estimates show that approximately 20% of women have nephroptosis, but fewer have associated symptoms. Interestingly, 70% of cases³ of nephroptosis occur on the right side. 

Treatment options for floating kidneys

Doctors don't recommend undergoing any medical procedures if you don't have symptoms from a floating kidney. If you have a floating kidney causing complications, you may see improvements after undergoing a laparoscopic nephropexy. 

To perform a laparoscopic nephropexy, your surgeon makes a small cut in your abdomen to move your floating kidney into the correct position. From there, they tether or secure your kidney in place. Some surgeons may tether the kidney using your muscle or fascia.

Another option is the "sliding clip" technique⁴ which uses sutures and nonabsorbable polymer clips. 

Either way, the surgery is safe and effective for managing symptoms associated with a floating kidney and generally has a short recovery period. 

The lowdown

We don’t know much about floating kidneys, and there is little research on the topic. Fortunately, most people with a floating kidney don't experience symptoms.

If you have abdominal pain or feel like a ball is rolling in your abdomen when you move from a lying position to sitting up, talk to your doctor to see whether you have a floating kidney. There are excellent treatment options available.