Venugopal P
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10 Mar 2023 08:34:24 AMRenal Dimension Measurements
Dear All,
The need for measuring the Renal Dimensions is not new as
can be found in the literature. In early days, there were considerable
limitations due to nonavailability of suitable techniques to measure. Hence
earlier studies depended mainly on autopsy studies.
Pourteyron (1872) by Autopsy Studies reported the Renal size
in men and women. In Men Rt Kidney averaged 11.4 cms in length and 6.5 cms in
width while the Lt Kidney was 12.0cms in length and 6.7 cms in width. In women
it was 10.8 (length) and 5.9cms (width) for Rt Kidney and 11.6cms (length) and
6.0cms (Width). As to the weight of the kidneys, he found that it was 141 g for
RT Kidney and
152 g for Lt Kidney in men. It was 115g for Rt and 124g for
left for women. Thoma (1882) found the left kidney to be 5 to 7 per cent
heavier than the right.
Though roentgenographic studies were introduced after the
discovery of X-Rays, a detailed study was made of renal dimensions by Schroeder
(1944). He measured the kidneys of healthy men and women by X-Ray and found in
men the Rt Kidney measured 13.4 X 6.3Cms (Length and Width) and 13.7 X 6.2Cms
for Lt Kidney. In women the measurements were: Rt Kidney – 12.9 X 5.9 and Lt
Kidney – 12.9 X 6.0. The average Surface area of Rt Kidney was 58.7 Cm2
in males and 60.2 Cm2 in Females.
In Hans MoeIl (1956) study the right kidney measures 12.7 x
6.3 cm, the left 13.2 x 6.4 cm, the total area being 129.6 cm2. Some
of the study during that time stressed on the importance of surface area rather
than the length of the kidney. When we were in training, we had to measure the
length of the kidney routinely when interpreting a KUB and IVU. Hodson (1962) popularized
the concept that the height of the individual in Inches represented the Surface
area of the kidney measured as square Cms. Subodh Kumar Yadav, Abhishek Karn*,
2017 (Nepal) found no correlation between height of the person and Renal
Length.
In 1970, I did a study on measuring the surface area of the
kidney by plotting the renal parenchymal area on a graph paper from IVU and
measuring it accurately in square mm (unpublished study). This was useful
especially in VUR’s where enormous parenchymal loss could be observed. The
concept of Segmental loss and/or Global loss could be discerned.
Renal size estimation can be performed measuring renal
length, renal volume, cortical thickness or volume. The most accurate of these
parameters is renal volume as the shape of kidney varies considerably. Renal
length is, however, the most clinically useful parameter, due to its low
inter-observer variation and better reproducibility. Different imaging
modalities such as KUB, IVU, US, CT and MRI have been used to estimate renal
size. However, the most accurate of these modalities are the MRI and CT,
because these can acquire three-dimensional data and, therefore, do not rely on
geometric assumption to estimate organ volume unlike the ultrasonography that
is used to measure kidney size in two-dimensional nature. However, it should be
realized that none of these measurements are accurate and they underestimate
the Renal Dimensions. Cheong et al (2007)
comparing US and MRI found that US is known to underestimate renal size by
about 20-29 per cent, while MRI underestimates it by about 4-5 per cent.
Carrasco et al have
shown that renal length gradually decreases as age advances and this decrease
accelerates after the seventh decade of life. This observation has been
confirmed by Muthusami et al (2014, a study from Pondicherry). They found that there
was significant decline in bilateral renal length after the age of sixty years.
The explanation is that the number of nephrons per normal kidney which varies
between 400,000 and 1,000,000, diminishes with advancing age and sex.
Egberongbe Adedeji (2014) mentioned that it is valuable to have a set of standard
sonographic measurements to use when these patients are examined in a given
population and because of the ease of availability US could be used for this in
spite of its limitations. He also added that each country has variations in
Kidney size which should be taken into reckoning. The reasons for this were
ascribed to be due to difference in height, weight, BSA, BMI and other
anthropometric measurements among races. P Muthusami et al (2014) opined
that commonly quoted renal dimensions, largely derived from studies performed
in Caucasian populations, were not applicable to the Indian people. Renal
lengths in our population were smaller than those in the Caucasian population.
They were similar to the values reported from Pakistan, Malaysia.
Comparison of renal lengths reported by US
Country |
Renal
Length |
||
Side |
Male |
Female |
|
India - South |
R L |
9.68 9.75 |
9.52 9.67 |
India North |
R L |
9.95 9.97 |
9.13 9.21 |
Pakistan |
R L |
10.6 10.6 |
10.3 10.3 |
Malaysia |
R L |
10.2 10.5 |
9.8 10.0 |
Hsuan-An
Su, Chien-Hsing Wu* et al (2019) studied the Ultrasonographic renal
measurements of male and female subject in Taiwan
Parameters |
All |
Male |
Female |
RL (cm) |
10.62±0.69 |
10.76±0.66 |
10.41±0.67 |
RW (cm) |
4.78±0.75 |
4.99±0.73 |
4.46±0.66 |
RCT (cm) |
1.46±0.32 |
1.51±0.31 |
1.39±0.31 |
LL (cm) |
10.76±0.70 |
10.87±0.69 |
10.59±0.68 |
LW (cm) |
5.10±0.64 |
5.29±0.60 |
4.82±0.59 |
LCT (cm) |
1.49±0.30 |
1.52±0.29 |
1.45±0.29 |
Data shown as mean ± S.D. Abbreviations: RL, right renal
length; RW, right renal width; RCT, right cortical thickness; LL, left renal
length; LW, left renal width; LCT, left cortical thickness |
H Krishnamoorthy
and P. Venugopal (2011, IJU, 27 (2): 171) published a review article on ‘Measurement
of renal dimensions in vivo: A critical appraisal’ in which all
types of Renal Dimension assessments were studied.
https://www.indianjurol.com/article.asp?issn=0970-1591;year=2011;volume=27;issue=2;spage=169;epage=175;aulast=Moorthy (PDF available)
https://www.indianjurol.com/temp/IndianJUrol272169-6255499_014415.pdf
With warm Regards,
Venu
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