Renal volume of five-year-old preterm children are not different than full-term controls

Abstract Objective: In previous studies, smaller renal volumes were reported in prematurely born infants, however, these renal volumes were not corrected for body surface area, the main determinant of renal size. Given the rapid growth of the renal cortex after premature birth, the authors hypothesized that corrected volumes would not differ from healthy controls. Methods: Ambispective cohort study with prospective follow-up of prematurely born babies in a large specialized center and retrospectively recruited healthy control group. Children were assessed for renal length and renal volumes at age 5 by three independent ultrasonographers. Detailed anthropometry, blood pressure and renal function were also obtained. Age independent z-scores were calculated for all parameters and compared using descriptive statistics. Results: Eighty-nine premature study participants (median 32 weeks gestational age) and 33 healthy controls (median 38 weeks gestational age) were studied. Study participants did not differ in age, sex, Afro-Colombian descent, height, blood pressure, serum creatinine, or new Schwartz eGFR. Premature study participants had a significantly lower weight (17.65 ± 2.93 kg) than controls (19.05 ± 2.81 kg, p = 0.0072) and lower body surface area. The right renal volumes were significantly smaller (39.4 vs 43.4 mL), but after correction for body surface area, the renal volume and renal length z-scores were identical for both kidneys (mean right kidney -0.707 vs -0.507; mean left kidney -0.498 vs -0.524, respectively). Conclusion: Renal volumes need to be corrected to body surface area. After correction for body surface area, 5-year-old healthy and prematurely born children have comparable renal volumes.

Relationship between estimated foetal weight and maternal renal volume in normal pregnant women in Bayelsa state, South-South Nigeria

Background: The weight of the foetus is an important factor to consider when determining the outcome of pregnancy. The birth weight is reliable in predicting perinatal outcome. Excessive and low weights of the baby are associated with increased risk of newborn complications during labour, delivery and postpartum. The objective of the study was to determine the relationship between estimated foetal weight and maternal renal dimensions and volume in normal pregnant women in Bayelsa State, Nigeria.Methods: This prospective, descriptive, cross-sectional study was conducted at the Obstetrics and Gynaecology, and Radiology Departments of the two tertiary hospitals in Bayelsa State, Nigeria, from July to December, 2021. Sonographic assessments of estimated foetal weight and the maternal renal dimensions and volume in 400 consecutive normal pregnant women in both tertiary institutions were done, after obtaining written informed consent from them. Data were entered into a pre-designed proforma, and analysed using Statistical Product and Service Solutions for windows� version 25, (SPSS Inc.; Chicago, USA). Results were presented in frequencies and percentages for categorical variables and mean and standard deviation for continuous variables.Results: A total of 400 pregnant women were scanned. There was a valid relationship between right renal antero-posterior diameter (?= 0.32; p �010), right renal width (?= 0.32; p �007), right renal volume (?= 0.32; p �007) and estimated foetal weight. The left renal width and renal volume showed the same trend as the right parameters with slight differences in values.Conclusions: This study revealed that estimated foetal weight increased with increase in maternal renal volume and dimensions.

Assessment of renal function and renal morphology in preterms and term newborns / 中华实用儿科临床杂志

Objective To explore the relationship between renal volume and function in the preterm and term newborns at different gestational ages.Methods This study was conducted at the First Affiliated Hospital of Zhengzhou University from October 2016 to March 2018.A total of 626 newborns with different gestational ages were included and the renal volume was determined by ultrasonography.Blood samples were taken for laboratory tests to detect renal function including urea,creatinine,uric acid and estimated glomerular filtration rate.Results A total of 352 preterm and 274 full term newborns were enrolled at birth.The mean gestational age of the neonates was (36.0 ± 3.5) weeks and the mean birth weight was (2.59 ±0.77) kg.The mean renal volume of the preterm infants was (19.57 ±4.30) cm3 and estimated glomerular filtration was (21.68 ± 5.99) mL/(min · 1.73 m2);the mean renal volume of the term infants was(23.03 ± 3.80) cm3 and estimated glomerular filtration was(46.60 ± 10.21) mL/(min · 1.73 m2).The renal volume and estimated glomerular filtration of term infants was significantly greater compared to the preterm infants (t =12.96,33.10,all P ＜ 0.001).The renal volume was highly linear positively correlated with gestational age,birth weight and birth length (r =0.546,0.605,0.592,all P ＜ 0.001).The renal volume was highly linear positively correlated with estimated glomerular filtration(r =0.396,P ＜ 0.001).The renal volume was negatively correlated with urea,creatinine and uric acid(r =-0.210,-0.280,-0.176,all P ＜ 0.001).Conclusions The renal volume increases with gestational age and birth weight in neonates.Estimated glomerular filtration increases with renal volume in neonates.The preterm infants have immaturity kidney size and poor development so that they need special medical care.

Effect of the ratio of living related donor renal volume to recipient body surface area on early function of transplanted kidney / 器官移植

Objective To investigate the relationship between the ratio of living related donor renal volume (RV) to recipient body surface area (BSA) (RV/BSA) and early postoperative function of transplanted kidney. Methods Clinical data of 120 pairs of donors and recipients undergoing living related renal transplantation were retrospectively analyzed. According to the RV/BSA ratio, the recipients were divided into group A (RV/BSA<65.33 mL/m2), group B (RV/BSA 65.33~76.49 mL/m2), group C (RV/BSA 76.50~96.96 mL/m2) and group D (RV/BSA > 96.96 mL/m2). The postoperative estimated glomerular filtration rate (eGFR) of recipients was compared among 4 groups. The correlation between the RV/BSA and eGFR of recipients at postoperative 6 and 12 months was analyzed. Results The eGFR at postoperative 6 month in group A was significantly lower than that in groups B, C and D (t=2.313, 2.947, 5.903; all P<0.05). The eGFR at postoperative 12 month in group A was also significantly lower than that in groups B, C and D (t=2.189, 2.433, 2.909;all P<0.05). The RV/BSA was significantly correlated with the eGFR of recipients at postoperative 6 and 12 months (all P<0.05).Conclusions RV/BSA is intimately correlated with the early function of transplanted kidney after living related renal transplantation.

Uso de sirolimus en pacientes pediátricos con poliquistosis renal autosómica dominante / Use of sirolimus in pediatric patients with autosomal dominant polycystic kidney disease

La poliquistosis renal autosómica dominante (PQRAD) se caracteriza por la aparición de quistes renales. Objetivos: Evaluar el crecimiento del volumen renal y de los quistes en los pacientes tratados con sirolimus, en comparación con aquellos que reciben el tratamiento habitual para la PQRAD; evaluar la aparición de efectos adversos relacionados con el uso de sirolimus; evaluar los cambios en la presión arterial, la proteinuria y el filtrado glomerular (FG) estimado. Materiales y métodos: Durante 24 meses se asignaron al azar 12 pacientes con PQRAD a un grupo de tratamiento con sirolimus (6 pacientes recibieron sirolimus 2 a 3 mg/m2/día, con un máximo de 5 mg/día) o a un grupo control (bajo tratamiento habitual). Resultados: De los 12 pacientes, los 6 pertenecientes al grupo de tratamiento con sirolimus tuvieron, al final del estudio, un aumento del volumen renal total y del volumen quístico del 13% y el 32%, respectivamente. En el grupo control, los 6 pacientes restantes tuvieron aumentos del 11% y el 23%, respectivamente. El FG fue normal para ambos grupos. La proteinuria para los grupos de sirolimus y control fue inicialmente 7.3 mg/m2/h y 6 mg/m2/h, respectivamente. Al finalizar el estudio era normal para ambos grupos. Tres pacientes tenían hipertensión arterial, pero a los 24 meses la presión arterial fue normal. Los efectos adversos observados fueron: anemia, diarrea y úlceras bucales. Conclusiones: El sirolimus no disminuyó el volumen renal ni el quístico. No hubo un aumento significativo en la proteinuria o una disminución en el FG. La media de la presión arterial se mantuvo normal.

Autosomal Dominant Polycystic Kidney Disease (ADPKD) is characterized by the develop-ment of kidney cysts. Objectives: To assess the growth of kidney and cystic volume in patients treated with rapamycin compared with patients receiving the usual treatment for ADPKD; assess the occurrence of adverse effects associated with the use of sirolimus; evaluate changes in blood pressure, proteinuria and estimated glomerular filtration rate (eGFR). Materials and methods: For a 24-month period, 12 patients with ADPKD were randomly allocated to a sirolimus group (6 patients, received rapamycin, 2-3 mg/m2/day, max. 5 mg/day) and the other 6 patients were allocated to a control group (receiving conventional treatment). Results: Out of the 12 patients, the 6 patients in the sirolimus group had a total increase in kidney and cystic volume of 13% and 32%, respectively, by the end of the study. In the control group, the other 6 patients had increases of 11% and 23%, respectively. eGFR was normal in both groups. Baseline proteinuria was 7.3 mg/m2/hour and 6 mg/m2/hour in the sirolimus- and control groups, respectively. By the end of the study, it was normal in both groups. Three patients had high blood pressure at baseline, but it was normalized at 24 months. Adverse effects were: anemia, diarr-hea, and mouth sores. Conclusions: Sirolimus did not reduce kidney and cystic volume. No significant increase in proteinuria or decrease in eGFR were observed. Mean blood pressure remained normal.

Caffeine intake by patients with autosomal dominant polycystic kidney disease

Because caffeine may induce cyst and kidney enlargement in autosomal dominant polycystic kidney disease (ADPKD), we evaluated caffeine intake and renal volume using renal ultrasound in ADPKD patients. Caffeine intake was estimated by the average of 24-h dietary recalls obtained on 3 nonconsecutive days in 102 ADPKD patients (68 females, 34 males; 39 ± 12 years) and compared to that of 102 healthy volunteers (74 females, 28 males; 38 ± 14 years). The awareness of the need for caffeine restriction was assessed. Clinical and laboratory data were obtained from the medical records of the patients. Mean caffeine intake was significantly lower in ADPKD patients versus controls (86 vs 134 mg/day), and 63% of the ADPKD patients had been previously aware of caffeine restriction. Caffeine intake did not correlate with renal volume in ADPKD patients. There were no significant differences between the renal volumes of patients in the highest and lowest tertiles of caffeine consumption. Finally, age-adjusted multiple linear regression revealed that renal volume was associated with hypertension, chronic kidney disease stage 3 and the time since diagnosis, but not with caffeine intake. The present small cross-sectional study indicated a low level of caffeine consumption by ADPKD patients when compared to healthy volunteers, which was most likely due to prior awareness of the need for caffeine restriction. Within the range of caffeine intake observed by ADPKD patients in this study (0-471 mg/day), the renal volume was not directly associated with caffeine intake.

Función renal relativa normalizada por volumen en la gamagrafía con 99mTc-DMSA: estudio basado en una población pediátrica / Volume normalized relative renal function in 99mTc-DMSA scintigraphy: study in a paediatric population

Objetivo Evaluar las diferentes características diagnósticas de la función renal relativa (FRR) y de la función renal relativa normalizada por volumen renal relativo (FRRN), con el fin de analizar la posible mejora diagnóstica que implicaría su uso conjunto. Métodos Hemos estudiado con 99mTc-DMSA 952 unidades renales (riñones individuales), que pertenecían a 476 pacientes pediátricos (269 niñas) de edades comprendidas entre 0 y 11 años. De ellas, 355 unidades renales se consideraron patológicas a partir del análisis visual gammagráfico. Se determinaron los puntos de corte más apropiados para establecer los valores normales de las funciones FRR y FRRN, considerando como patrón de referencia al análisis visual gammagráfico. Se realizaron curvas ROC y se calculó el índice “J de Youden” y la exactitud para diferentes puntos de corte desde 42 por ciento hasta 50 por ciento, tanto para la FRR como para la FRRN. Se realizó también un análisis bayesiano (global y parcial clasificando las unidades renales por indicaciones clínicas) de la FRR y la FRRN. Resultados Para la FRR el mejor punto de corte fue 45 por ciento y para la FRRN fue 47 por ciento. El análisis bayesiano global mostró mejores resultados de los diferentes parámetros estadísticos para la FRRN. El análisis bayesiano parcial indicaba un importante incremento de la sensibilidad en pacientes con patología de dilatación de vía: de 10 por ciento (FRR) a 74.6 por ciento (FRRN); y con pielonefritis aguda: de 29.2 por ciento (FRR) a 66.2 por ciento (FRRN) mientras que en pacientes con nefropatías crónicas la sensibilidad fue similar (70.1 por ciento). Conclusión El cálculo de la FRRN (punto de corte 47 por ciento) proporciona información útil y complementaria a la FRR, ya que cuantifica la calidad relativa del riñón independientemente del volumen renal y refleja mejor los hallazgos gammagráficos.

Purpose To assess the different diagnostic features of relative renal function (RRF) and volume normalized relative renal function (NRRF) with the aim of analysing the possible diagnostic improvement that would imply their joint use. Methods We studied 952 kidneys with 99mTc-DMSA, belonging to 476 paediatric patients (269 girls) aged 0-11 years. 355 out of total were considered pathologic (visual analysis). The most appropriate cut-off points for establishing normality of RRF and NRRF were determined, considering as gold standard the visual scintigraphic analysis. R.O.C. curves were performed, J Youden index and accuracy were calculated for the different cut-off points from 42 percent to 50 percent for RRF and NRRF. A bayesian analysis (global and partial according to clinical indications) of RRF and NRRF was also performed. Results For RRF the better cut-off point was 45 percent and for NRRF 47 percent. The global bayesian analysis showed better values of the different statistical parameters for NRRF. Partial bayesian analysis indicated an important increment of sensitivity in patients with dilated pyelocalicial system: from 10 percent (RRF) to 74.6 percent (NRRF); and acute pyelonephritis: from 29.2 percent (RRF) to 66.2 percent (NRRF) while the sensitivity in patients with chronic nephropathy remained stable (70.1 percent). Conclusion NRRF calculation (cut-off 47 percent) provides useful and additional information to RRF, as it quantifies the relative quality of kidney tissue regardless of renal volume and better reflects better the scintigraphic findings.

Evaluation of Renal Volume by Ultrasonography in Patients with Essential Hypertension in Ile-Ife; South Western Nigeria

To determine renal volume in adult patients with essential hypertension and correlate it with age, sex, body mass index (BMI), body surface area (BSA) and duration of hypertension. Patients and methods: A total of 150 patients (75 males, 75 females) with essential hypertension and normal renal status were evaluated sonographically in this prospective study. Fifty healthy individuals (25 males, 25 females) without hypertension were also evaluated as control. Renal volume was then calculated from the kidney's length, width and anterio-posterior diameter using the formula LWAP0.523. Results: The range of renal volume obtained was 51.65205.02 cm3, with a mean of 114.06929.78 cm3 for the left kidney and 47.37177.50 cm3 with a mean of 106.14925.42 cm3 for the right kidney. The mean volumes of the right and left kidneys in males (112.98925.56 cm3 and 123.11932.49 cm , respectively), were significantly higher than in females (99.31923.07 cm3 and 105.01923.77 cm3, respectively). Renal volume correlated significantly with BSA and BMI but decreased with age. The renal volume showed no correlation with duration of hypertension. Conclusion: Renal volume is higher in the left than the right kidney in hypertensive patients of both sexes and female hypertensive patients have smaller kidney size compared to males. The study also shows that volume of both kidneys decreases with age and positive correlation between renal volume, BSA and BMI. However, there is no correlation between renal size and duration of hypertension.

Evaluation of Functional Renal Volume with 99mTc-DMSA SPECT in Patients with Diabetes Mellitus / 대한신장학회잡지

About 40% of patients with diabetes mellitus develops to diabetic nephropathy, and these patients show increment of glomerular filtration rate and renal volume at early phase. 99mTc-DMSA SPECT (single photon emission computed tomography) can measure a functional renal volume because 99mTc- DMSA it is taken up by the viable proximal tubular cells located in the renal cortex. To evaluate the renal volume in early diabetic nephropathy, we compared functional renal volume between diabetic patients and control, renal transplantation donor. 99mTc-DMSA was injected intravenously and SPECT was done after 2 hours in 15 diabetic patients, 18 renal transplantation donors, and 2 patients with end stage renal disease due to chronic glomerulonephritis. In diabetic patients with creatinine clearance more than 30ml/min and proteinuria, right and left renal volume were 247+/-22ml/BSA(m2), 256+/-37ml/BSA (m2), which were greater than those of diabetic patients with normal renal function and without proteinuria, or renal transplantation donors(P<0.05). In conclusion, we measured the functional renal volume by 99mTc-DMSA SPECT. Renal volume of diabetic patients with proteinuria were larger than the volume of control group or diabetic patients with normal renal function and without proteinuria. 99mTc-DMSA SPECT was thought to be useful test a for the measurement of functioning renal volume.

Measurement of Renal Volume of Pregnant Women for the Predictiveness / 中华超声影像学杂志

The measurement of renaI volume by ultrasound was carried out in 488 women with sigleton pregnahey.Sixty-eight women had infants with the intrauterine Browth retardation(IUGR).The average of renal volume in nofmal pregnant females and females with IUGR increased 57.2% and 8.4% respectively during trimester.Hence,the neonatal weight outcomes were cortelated with the renal volume in their mothers.The specficity of measurement was 96%,and the sensitivity was 65%.The sensitivety was influenced by type of IUGR and individual difference of renal vohme.The positive predictive vaIue was 74%.