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Dabers T, Sass P, Fechner F, Weyer J, Völzke H, Mahnken AH, Lorbeer R, Mensel B, Stracke S. Age- and Sex-Specific Reference Values for Renal Volume and Association with Risk Factors for Chronic Kidney Disease in a General Population-An MRI-Based Study. J Clin Med 2024; 13:769. [PMID: 38337463 PMCID: PMC10856696 DOI: 10.3390/jcm13030769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/14/2024] [Accepted: 01/15/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Renal volume (RV) is associated with renal function and with a variety of cardiovascular risk factors (CVRFs). We analysed RV using magnetic resonance imaging (MRI) in a large population-based study (Study of Health in Pomerania; SHIP-TREND) to find sex- and age-specific reference values for RV and to test the influence of several markers on RV. The main objective is to describe reference values for RV in people from the general population without kidney disease. METHODS 1815 participants without kidney disease (930 women) aged 21-81 years were included in our study. Right and left RV with and without body surface area (BSA) indexation were compared among three age groups (22-39 years, 40-59 years, 60-81 years) by median and interquartile range and tested separately in women and men. RESULTS The estimated glomerular filtration rate (eGFR), serum uric acid, and right and left RV were higher in men compared to women (all p < 0.001). Left kidneys were larger than right kidneys (both sexes). With age, RV showed a continuously decreasing trend in women and an upside-down U-shaped relation in men. In multivariable linear regression models, current smoking (β = 14.96, 95% CI 12.12; 17.79), BSA (β = 97.66, 95% CI 90.4; 104.93), diastolic blood pressure (β = 0.17, 95% CI 0.01; 0.32), and eGFR (β = 0.57, 95% CI 0.50; 0.65) were positively associated with both left and right RV, whereas uric acid (β = -0.03, 95% CI -0.05; -0.01) showed an inverse association with RV. Interestingly, the same eGFR correlated with higher RV in men compared to women. CONCLUSION Reference values for RV are different for age groups and sex. For any given age, female kidneys are smaller than male kidneys. RV associates positively with eGFR, but for any chosen eGFR, renal volume in females is lower compared to males. RV decreases with age, but in men showed a U-shaped correlation. This may reflect hyperfiltration and glomerular hypertrophy associated with the presence of CVRF in middle-aged males.
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Affiliation(s)
- Thomas Dabers
- Nephrology, Internal Medicine A, University Medicine Greifswald, 17475 Greifswald, Germany; (T.D.)
- KfH Renal Center, 17475 Greifswald, Germany
| | - Peter Sass
- Nephrology, Internal Medicine A, University Medicine Greifswald, 17475 Greifswald, Germany; (T.D.)
| | - Fritz Fechner
- Nephrology, Internal Medicine A, University Medicine Greifswald, 17475 Greifswald, Germany; (T.D.)
| | - Julian Weyer
- Nephrology, Internal Medicine A, University Medicine Greifswald, 17475 Greifswald, Germany; (T.D.)
| | - Henry Völzke
- Institute for Community Medicine—SHIP Clinical-Epidemiological Research, University Medicine Greifswald, 17475 Greifswald, Germany;
| | - Andreas Horst Mahnken
- Department of Diagnostic & Interventional Radiology, Philipps-University Marburg, 35037 Marburg, Germany;
| | - Roberto Lorbeer
- Department of Radiology, University Hospital, LMU Munich, 80539 Munich, Germany;
| | - Birger Mensel
- Department of Diagnostic & Interventional Radiology, Philipps-University Marburg, 35037 Marburg, Germany;
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Central Hospital Bad Berka, 99438 Bad Berka, Germany
| | - Sylvia Stracke
- Nephrology, Internal Medicine A, University Medicine Greifswald, 17475 Greifswald, Germany; (T.D.)
- KfH Renal Center, 17475 Greifswald, Germany
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Matsuo M, Yamagishi F, Higuchi A. A Pilot Study of Prediction of Creatinine Clearance by Ellipsoid Volumetry of Kidney Using Noncontrast Computed Tomography. JMA J 2019; 2:60-66. [PMID: 33681514 PMCID: PMC7930707 DOI: 10.31662/jmaj.2018-0021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 12/17/2018] [Indexed: 12/17/2022] Open
Abstract
Introduction Aging is associated with a decline in kidney volume and function. The purpose of this study is to investigate a direct relationship between kidney volume and function in the elderly population and to challenge whether kidney function could be predictable by using the kidney volume. Methods We conducted a chart review of 366 patients who underwent abdominal computed tomography (CT) and renal function measurement prior to gastrointestinal surgery. The kidney volume was calculated by the ellipsoid method using a coronal section of noncontrast CT images. Results The patients were 72.2 ± 13.2 years of age, and 39.0% were female. Their average measured creatinine clearance (mCCr) was 72.0 ± 21.5 mL/min. The average kidney volume was 100.3 ± 27.6 cm3 in the right kidney and 109.3 ± 30.9 cm3 in the left. There was a significant positive correlation between the total kidney volume and mCCr. Multivariate regression analysis showed that age, diabetes mellitus, and total kidney volume were dependent variables with which to predict mCCr. The use of total kidney volume predicted mCCr of ≥50 mL/min with moderate accuracy (area under the curve = 0.782; 95% confidence interval = 0.692-0.871). Conclusions These results indicate a direct relationship between kidney volume and function in the elderly and might provide a pilot method which estimates the renal function using kidney morphology obtained from pre-existing CT images.
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Affiliation(s)
- Mitsuhiro Matsuo
- Department of Internal Medicine, Itoigawa General Hospital, Itoigawa, Niigata, Japan
| | - Fuminori Yamagishi
- Department of Surgery, Itoigawa General Hospital, Itoigawa, Niigata, Japan
| | - Akiko Higuchi
- Department of Internal Medicine, Itoigawa General Hospital, Itoigawa, Niigata, Japan
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Chua ME, Kim JK, Gnech M, Ming JM, Amir B, Fernandez N, Lorenzo AJ, Farhat WA, Hebert D, Dos Santos J, Koyle MA. Clinical implication of renal allograft volume to recipient body surface area ratio in pediatric renal transplant. Pediatr Transplant 2018; 22:e13295. [PMID: 30315631 DOI: 10.1111/petr.13295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/04/2018] [Accepted: 08/27/2018] [Indexed: 12/18/2022]
Abstract
Our study aims to assess the clinical implication of RAV/rBSA ratio in PRT as a predictor for attained renal function at 1 year post-transplantation and its association with surgical complications. A retrospective cohort was performed for PRT cases from January 2000 to December 2015 in our institution. Extracted clinical information includes the recipient's demographics, donor type, renal allograft characteristics, arterial, venous and ureteral anastomoses, vascular anastomosis time while kidney off ice, overall operative time, and estimated blood loss. The RAV/rBSA was extrapolated and assessed for its association with renal graft function attained in 1 year post-transplantation and surgical complications within 30-day post-transplantation. A total of 324 PRTs cases were analyzed. The cohort consisted of 187 (52.4%) male and 137 (42.3%) female recipients, with 152 (46.9%) living donor and 172 (53.1%) deceased donor renal transplants, and an overall median age of 155.26 months (IQR 76.70-186.98) at time of renal transplantation. The receiver operating characteristic identified that a RAV/rBSA ratio of 135 was the optimal cutoff in determining the renal graft function outcome. Univariate and multivariate analyses revealed the relative OR for RAV/rBSA ≥ 135 ratio in predicting an eGFR ≥ 90 attained within 1 year post-transplant was highest among younger pediatric recipients (<142.5 months) of deceased kidney donors (OR = 11.143, 95% CI = 3.156-39.34). Conversely, Kaplan-Meier analysis revealed that RAV/rBSA ratio ≥ 135 is associated with lower odds of having eGFR <60 (OR = 0.417, 95% CI = 0.203-0.856). The RAV/rBSA ratio was not associated nor predictive of transplant-related surgical complications. Our study determined that the RAV/rBSA ratio is predictive of renal graft function at 1-year PRT, but not associated with any increased surgical complications.
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Affiliation(s)
- Michael E Chua
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Institute of Urology, St. Luke's Medical Center, Quezon City, Philippines
| | - Jin Kyu Kim
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michele Gnech
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Surgery, University of Padova, Padua, Veneto, Italy
| | - Jessica M Ming
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Surgery, University of New Mexico, Albuquerque, New Mexico
| | - Bisma Amir
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nicolas Fernandez
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Armando J Lorenzo
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Walid A Farhat
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Diane Hebert
- Department of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Joana Dos Santos
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Martin A Koyle
- Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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The diagnostic value of serum creatinine and cystatin c in evaluating glomerular filtration rate in patients with chronic kidney disease: a systematic literature review and meta-analysis. Oncotarget 2017; 8:72985-72999. [PMID: 29069842 PMCID: PMC5641185 DOI: 10.18632/oncotarget.20271] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 07/30/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Serum biomarkers, such as serum creatinine (SCr) and serum cystatin C (SCysC), have been widely used to evaluate renal function in patients who have chronic kidney disease (CKD). OBJECTIVE This article aims to assess the value of determining SCr and SCysC levels in patients that have long-term kidney disease. Approaches: MEDLINE, EmBase, the Cochrane Library and other databases were searched using both MeSH terms and text words to collect research that assessed the diagnostic value of using SCr and SCysC to evaluate Glomerular Filtration Rate (GFR) in patients with CKD. Data were converted into fourfold tables. Summary Receiver Operating Characteristic Curves and meta-analyses were accomplished via Meta-Disc version 1.4. RESULTS In total, 21 relevant articles involving 3112 study subjects were included in our review. Results showed that the collective sensitivity for SCr and SCysC was 0.77 (95% CI: 0.69-0.84) and 0.87 (95% CI: 0.82-0.91), respectively. The pooled specificity for SCr and SCysC was 0.91 (95% CI: 0.86-0.94) and 0.87 (95% CI: 0.82-0.91), respectively. Subgroup analyses demonstrated that when GFR cut-off values are set to 60 (ml/min/1.73 m2), the pooled sensitivity is 0.94 (95% CI: 0.90-0.96) for SCysC and 0.75 (95% CI: 0.68-0.82) for SCr. CONCLUSIONS The diagnostical accuracy for impaired kidney function favors SCysC. Confidence intervals for the pooled sensitivity and specificity for SCr and SCysC overlap. However, SCysC is more sensitive for estimating GFR than SCr when GFR cut-off values are set to 60 (ml/min/1.73 m2).
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Narasimhamurthy M, Smith LM, Machan JT, Reinert SE, Gohh RY, Dworkin LD, Merhi B, Patel N, Beland MD, Hu SL. Does size matter? Kidney transplant donor size determines kidney function among living donors. Clin Kidney J 2017; 10:116-123. [PMID: 28638611 PMCID: PMC5469570 DOI: 10.1093/ckj/sfw097] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 08/16/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Kidney donor outcomes are gaining attention, particularly as donor eligibility criteria continue to expand. Kidney size, a useful predictor of recipient kidney function, also likely correlates with donor outcomes. Although donor evaluation includes donor kidney size measurements, the association between kidney size and outcomes are poorly defined. METHODS We examined the relationship between kidney size (body surface area-adjusted total volume, cortical volume and length) and renal outcomes (post-operative recovery and longer-term kidney function) among 85 kidney donors using general linear models and time-to-chronic kidney disease data. RESULTS Donors with the largest adjusted cortical volume were more likely to achieve an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 over a median 24-month follow-up than those with smaller cortical volumes (P <0.001), had a shorter duration of renal recovery (1.3-2.2 versus 32.5 days) and started with a higher eGFR at pre-donation (107-110 versus 91 mL/min/1.73 m2) and immediately post-nephrectomy (∼63 versus 50-51 mL/min/1.73 m2). Similar findings were seen with adjusted total volume and length. CONCLUSIONS Larger kidney donors were more likely to achieve an eGFR ≥60 mL/min/1.73 m2 with renal recovery over a shorter duration due to higher pre-donation and initial post-nephrectomy eGFRs.
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Affiliation(s)
- Meenakshi Narasimhamurthy
- Division of Kidney Disease and Hypertension, Department of Medicine, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA
| | - Lachlan M. Smith
- Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA
| | - Jason T. Machan
- Biostatistics Core, Lifespan Hospital System, Departments of Orthopedic and Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Steven E. Reinert
- Lifespan Information Services, Lifespan Hospital System, Providence, RI, USA
| | - Reginald Y. Gohh
- Division of Renal Transplantation, Department of Medicine, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA
| | - Lance D. Dworkin
- Division of Kidney Disease and Hypertension, Department of Medicine, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA
| | - Basma Merhi
- Division of Kidney Disease and Hypertension, Department of Medicine, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA
| | - Nikunjkumar Patel
- Division of Kidney Disease and Hypertension, Department of Medicine, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA
| | - Michael D. Beland
- Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA
| | - Susie L. Hu
- Division of Kidney Disease and Hypertension, Department of Medicine, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA
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Lucisano G, Comi N, Pelagi E, Cianfrone P, Fuiano L, Fuiano G. Can renal sonography be a reliable diagnostic tool in the assessment of chronic kidney disease? JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2015; 34:299-306. [PMID: 25614403 DOI: 10.7863/ultra.34.2.299] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES Kidney size has been found to be correlated with anthropometric features and kidney function. Therefore, we postulate that if the conventionally measured renal sonographic parameters (pole-to-pole length, width, and parenchymal thickness) are taken according to standardized rules and corrected for body height, their association with kidney function could be strengthened, thus helping validate renal sonographic information for a better assessment of chronic kidney disease (CKD) status. METHODS This cross-sectional study included 72 stable adult patients with stage 1 to 4 CKD. Sonographic parameters were obtained from both kidneys and averaged, and the measurements obtained were further corrected for patients' body height. The glomerular filtration rate (GFR) was estimated by the Chronic Kidney Disease Epidemiology Collaboration equation. RESULTS Parenchymal thickness and renal length showed the highest correlation level with the GFR. This significant correlation, however, was greatly ameliorated by the correction for patients' body height (r = 0.537; P < .001; r = 0.510; P < .001, respectively). Of note, the product of these two parameters corrected for body height showed the best degree of correlation with the GFR (r = 0.560; P < .001), as confirmed by analysis of variance after subdivision of the population into CKD stage groups according to the GFR. Receiver operating characteristic curve analysis for discrimination of a GFR of less than 60 mL/min indentified the combined parameter as the one with the highest area under the curve (0.78; 95% confidence interval, 0.66-0.89), followed renal length corrected for height (area under the curve, 0.77; 95% confidence interval, 0.66-0.88). CONCLUSIONS Correction of renal sonographic parameters for body height strengthens the degree of the correlation of renal sonography with the GFR. The improved correlation with the GFR makes renal sonography a reliable tool for a more complete assessment of patients with CKD.
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Affiliation(s)
- Gaetano Lucisano
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy.
| | - Nicolino Comi
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Elena Pelagi
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Paola Cianfrone
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Laura Fuiano
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Giorgio Fuiano
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
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Tyson R, Logsdon SA, Werre SR, Daniel GB. Estimation of feline renal volume using computed tomography and ultrasound. Vet Radiol Ultrasound 2012; 54:127-32. [PMID: 23278991 DOI: 10.1111/vru.12007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 11/14/2012] [Indexed: 11/27/2022] Open
Abstract
Renal volume estimation is an important parameter for clinical evaluation of kidneys and research applications. A time efficient, repeatable, and accurate method for volume estimation is required. The purpose of this study was to describe the accuracy of ultrasound and computed tomography (CT) for estimating feline renal volume. Standardized ultrasound and CT scans were acquired for kidneys of 12 cadaver cats, in situ. Ultrasound and CT multiplanar reconstructions were used to record renal length measurements that were then used to calculate volume using the prolate ellipsoid formula for volume estimation. In addition, CT studies were reconstructed at 1 mm, 5 mm, and 1 cm, and transferred to a workstation where the renal volume was calculated using the voxel count method (hand drawn regions of interest). The reference standard kidney volume was then determined ex vivo using water displacement with the Archimedes' principle. Ultrasound measurement of renal length accounted for approximately 87% of the variability in renal volume for the study population. The prolate ellipsoid formula exhibited proportional bias and underestimated renal volume by a median of 18.9%. Computed tomography volume estimates using the voxel count method with hand-traced regions of interest provided the most accurate results, with increasing accuracy for smaller voxel sizes in grossly normal kidneys (-10.1 to 0.6%). Findings from this study supported the use of CT and the voxel count method for estimating feline renal volume in future clinical and research studies.
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Affiliation(s)
- Reid Tyson
- Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Tech, Blacksburg, VA 24061, USA.
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Abstract
Functional evaluation of the renal unit has often been quoted as a standard practice for management of stone disease of the upper urinary tract. However, there is very little available evidence from the existing literature to directly support or refute this practice. Here we try to critically review the existing literature on related questions, put into perspective its clinical utility and attempt to rationalize the concept of functional evaluation in patients of renal stone disease in the contemporary era of minimally invasive surgery.
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Affiliation(s)
- Rishi Nayyar
- Department of Urology, RML Hospital and PGIMER, New Delhi, India
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