ESPN 53rd Annual Meeting

ESPN 2021


 
Renal length normative values in children aged 0-18 years – multicenter study
LUKASZ OBRYCKI 1 JEDRZEJ SARNECKI 2 MARIANNA LICHOSIK 1 MALGORZATA SOPINSKA 3 MALGORZATA PLACZYNSKA 3 MALGORZATA STANCZYK 4 JULIA MIRECKA 4 AGNIESZKA WASILEWSKA 5 MACIEJ MICHALSKI 5 WERONIKA LEWANDOWSKA 6 TADEUSZ DEREZINSKI 6 MICHAL PAC 1 NATALIA SZWARC 7 KAROL ANNUSEWICZ 8 VIKTORIIA REKUTA 8 KAROLIS AžUKAITIS 9 AUGUSTINA JANKAUSKIENE 9 BOLESLAW KALICKI 3 KATARZYNA JOBS 3 MARCIN TKACZYK 4 JANUSZ FEBER 10 MIECZYSLAW LITWIN 1

1- DEPARTMENT OF NEPHROLOGY, KIDNEY TRANSPLANTATION AND HYPERTENSION, CHILDREN`S MEMORIAL HEALTH INSTITUTE, WARSAW, POLAND
2- DEPARTMENT OF RADIOLOGY, CHILDREN`S MEMORIAL HEALTH INSTITUTE, WARSAW, POLAND
3- DEPARTMENT OF PAEDIATRICS, PAEDIATRIC NEPHROLOGY AND ALLERGOLOGY, THE MILITARY INSTITUTE OF MEDICINE, WARSAW, POLAND
4- DEPARTMENT OF PEDIATRICS, IMMUNOLOGY AND NEPHROLOGY, POLISH MOTHERS MEMORIAL HOSPITAL RESEARCH INSTITUTE, LODZ, POLAND
5- DEPARTMENT OF RADIOLOGY, POLISH MOTHERS MEMORIAL HOSPITAL RESEARCH INSTITUTE, LODZ, POLAND
6- OUTPATIENT CLINIC “ESCULAP”, GNIEWKOWO, POLAND
7- DEPARTMENT OF PEDIATRICS, JAN BOGDANOWICZ CHILDREN`S HOSPITAL, WARSAW, POLAND
8- DEPARTMENT OF PAEDIATRICS, NUTRITION AND METABOLIC DISEASES, CHILDREN`S MEMORIAL HEALTH INSTITUTE, WARSAW, POLAND
9- CLINIC OF PEDIATRICS, FACULTY OF MEDICINE, VILNIUS UNIVERSITY, VILNIUS, LITHUANIA
10- DIVISION OF NEPHROLOGY, DEPARTMENT OF PEDIATRICS, THE CHILDREN’S HOSPITAL OF EASTERN ONTARIO, OTTAWA
 
Introduction:

 Kidney length measurement and its interpretation is an integral part of the diagnosis of pediatric nephrology diseases. The most widely used kidney length norms, published in 1984, are based on an American study including  203 non-necessarily healthy patients.

Material and methods:

 The aim of the study was to develop ultrasound-based normative values of kidney length in European healthy children and adolescents aged 0-18 years.

Our study included 1769 patients aged 0-18 years (877 boys; 50%), with normal glomerular filtration rate, no history of urinary tract infections, no kidney abnormalities in abdominal ultrasound, recruited in schools and kindergartens as well as in pediatric units in Poland and Lithuania. The examination was conducted in accordance with the standards of the Polish and European ultrasound societies.

Results:

Based on the ultrasound measurements, kidney length nomograms (including 2.5th; 25th; 50th; 75th; 90th and 97.5th percentiles) for patients aged 0-18 years were developed using quantile regression. There were no sex-related or patient position (supine or prone) differences in renal size. The median difference between the left and right kidney across all age categories was -1.00 mm (5th percentile = -6.7 mm, 95th percentile=+3.6 mm). Out of age, weight, height, body surface area and body mass index, the height was the most significant predictor or renal length (T=9.21, p<0.0001, relative importance = 25.8%). We also developed a formula to calculate the average kidney length (50th percentile) and the cut-off values for small (<2.5th percentile) and enlarged kidney (>97.5th percentile) using the patients height.

Conclusions:

 The main determinant of kidney length was height. Our results, based on a largest pediatric cohort to date, can serve as reference values in clinical practice and research studies.