Renal 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the kidney by plotting the renal parenchymal area on a graph paper from IVU and measuring it accurately in square mm (unpublished study).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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