We propose a novel kidney segmentation approach based on the graph cuts technique. The proposed approach depends on both image appearance and shape information. Shape information is gathered from a set of training shapes. Then we estimate the shape variations using a new distance probabilistic model which approximates the marginal densities of the kidney and its background in the variability region using a Poisson distribution refined by positive and negative Gaussian components. To segment a kidney slice, we align it with the training slices so we can use the distance probabilistic model. Then its gray level is approximated with a LCG with sign-alternate components. The spatial interaction between the neighboring pixels is identified using a new analytical approach. Finally, we formulate a new energy function using both image appearance models and shape constraints. This function is globally minimized using s/t graph cuts to get the optimal segmentation. Experimental results show that the proposed technique gives promising results compared to others without shape constraints.