Struttura complessa di Nefrologia e Dialisi, Azienda Ospedaliera G. Brotzu, Cagliari, Italy.
Istituto di Ricerca Biomedica e Genetica, Consiglio Nazionale delle Ricerche, Monserrato (Cagliari), Italy.
Nephrol Dial Transplant. 2020 Apr 1;35(4):640-647. doi: 10.1093/ndt/gfy270.
The relationship of kidney size to ageing, kidney function and kidney disease risk factors is not fully understood.
Ultrasound length and parenchymal kidney volume were determined from a population-based sample of 3972 Sardinians (age range 18-100 years). We then identified the subset of 2256 'healthy' subjects to define age- and sex-specific reference ranges (2.5-97.5 percentile) of kidney volume. Logistic regression (accounting for family clustering) was used to identify the clinical characteristics associated with abnormally large kidneys or abnormally small kidneys.
In the healthy subset, kidney volume and length increased up to the fourth to fifth decade of life followed by a progressive decrease in men, whereas there was a gradual kidney volume decrease throughout the lifespan of women. In the whole sample, independent predictors of lower kidney volume (<2.5 percentile for age and sex) were male sex, low body mass index, short height, low waist:hip ratio and high serum creatinine (SCr); the independent predictors of larger kidney volume (>97.5 percentile for age and sex) were younger age, female sex, diabetes, obesity, high height, high waist:hip ratio and lower SCr. Estimated heritability for kidney volume was 15%, and for length 27%; kidney volume correlated strongly with birthweight.
Overall, in a general healthy population, kidney measures declined with age differently in men and women. The determinants of kidney parenchymal volume include genetic factors and modifiable clinical factors.
肾脏大小与衰老、肾功能和肾脏疾病危险因素的关系尚未完全阐明。
从 3972 名撒丁岛人群（年龄 18-100 岁）中抽取一个基于人群的样本，通过超声确定肾脏长度和实质肾脏体积。然后，我们确定了 2256 名“健康”受试者的子集，以确定肾脏体积的年龄和性别特异性参考范围（2.5-97.5 百分位）。使用逻辑回归（考虑家族聚类）确定与肾脏过大或过小相关的临床特征。
在健康亚组中，肾脏体积和长度在第四至第五个十年达到高峰，随后男性逐渐下降，而女性在整个生命周期中则逐渐下降。在整个样本中，肾脏体积较小（<年龄和性别第 2.5 百分位）的独立预测因素为男性、低体重指数、矮小、低腰臀比和高血清肌酐（SCr）；肾脏体积较大（>年龄和性别第 97.5 百分位）的独立预测因素为年龄较小、女性、糖尿病、肥胖、较高的身高、较高的腰臀比和较低的 SCr。肾脏体积的遗传度估计为 15%，长度为 27%；肾脏体积与出生体重密切相关。
总体而言，在一般健康人群中，男性和女性的肾脏大小随年龄的变化不同。肾脏实质体积的决定因素包括遗传因素和可改变的临床因素。
