Department of Nephrology, Kidney Transplantation and Hypertension, Children's Memorial Health Institute, al. Dzieci Polskich 20, 04-730, Warsaw, Poland.
Department of Diagnostic Imaging, Children's Memorial Health Institute, Warsaw, Poland.
Pediatr Nephrol. 2022 May;37(5):1075-1085. doi: 10.1007/s00467-021-05303-5. Epub 2021 Oct 16.
Currently used pediatric kidney length normative values are based on small single-center studies, do not include kidney function assessment, and focus mostly on newborns and infants. We aimed to develop ultrasound-based kidney length normative values derived from a large group of European Caucasian children with normal kidney function.
Out of 1,782 children aged 0-19 years, 1,758 individuals with no present or past kidney disease and normal estimated glomerular filtration rate had sonographic assessment of kidney length. The results were correlated with anthropometric parameters and estimated glomerular filtration rate. Kidney length was correlated with age, height, body surface area, and body mass index. Height-related kidney length curves and table were generated using the LMS method. Multivariate regression analysis with collinearity checks was used to evaluate kidney length predictors.
There was no significant difference in kidney size in relation to height between boys and girls. We found significant (p < 0.001), but clinically unimportant (Cohen's D effect size = 0.04 and 0.06) differences between prone vs. supine position (mean paired difference = 0.64 mm, 95% CI = 0.49-0.77) and left vs. right kidneys (mean paired difference = 1.03 mm, 95% CI = 0.83-1.21), respectively. For kidney length prediction, the highest coefficient correlation was observed with height (adjusted R = 0.87, p < 0.0001).
We present height-related LMS-percentile curves and tables of kidney length which may serve as normative values for kidney length in children from birth to 19 years of age. The most significant predictor of kidney length was statural height.
目前使用的儿科肾脏长度参考值是基于小的单中心研究,不包括肾功能评估,并且主要集中在新生儿和婴儿。我们旨在开发基于大量具有正常肾功能的欧洲白种人儿童的超声肾脏长度参考值。
在 1782 名 0-19 岁的儿童中,有 1758 名没有现患或既往肾脏疾病且肾小球滤过率估计正常的个体进行了肾脏长度的超声评估。结果与人体测量参数和肾小球滤过率相关。肾脏长度与年龄、身高、体表面积和体重指数相关。使用 LMS 方法生成与身高相关的肾脏长度曲线和表。使用多元回归分析和共线性检查来评估肾脏长度的预测因子。
男孩和女孩的肾脏大小与身高之间没有显著差异。我们发现俯卧位与仰卧位(平均配对差异=0.64 毫米,95%置信区间=0.49-0.77)和左肾与右肾(平均配对差异=1.03 毫米,95%置信区间=0.83-1.21)之间存在显著(p<0.001)但临床意义不大的差异(Cohen's D 效应量=0.04 和 0.06)。对于肾脏长度预测,与身高的相关性最高(调整 R=0.87,p<0.0001)。
我们提出了与身高相关的 LMS-百分位数曲线和表,可作为 0-19 岁儿童肾脏长度的参考值。肾脏长度的最显著预测因子是身高。