Pediatric Radiology

, Volume 43, Issue 12, pp 1557–1565 | Cite as

The impact of hydration on renal measurements and on cortical echogenicity in children

  • Mooneera Peerboccus
  • Nasroolla Damry
  • Sanjiva Pather
  • Arnaud Devriendt
  • Freddy Avni
Original Article



Kidney ultrasonography is frequently performed in children; to date there are no specific guidelines regarding hydration before the examination.


Because certain renal measurements can be indicative of pathology, we used sequential US images to investigate the effect of standardised hydration in children relative to renal size, echogenicity and pelvic expansion.

Materials and methods

Thirty-one children (7 years to 14 years old) underwent US examinations before hydration (T0) and at 30 min (T30) and 60 min (T60) after ingesting water. We measured bladder volume, inter-polar kidney size, renal volume and anterior-posterior diameter of the pelvis. Cortical echogenicity was compared to that of the liver and spleen.


On the right side the increase in average inter-polar renal size was 2.5% at T30 and 2.6% at T60 (P < 0.05) compared to T0. On the left the increase was 3.8% at T30 and 4.3% at T60 (P < 0.05). Volume expansion for the right kidney was 16.8% at T30 and 14.0% at T60 (P < 0.05). On the left it was 12.9% at T30 and 10.2% at T60 (P < 0.05). Cortical echogenicity progressed from hypoechogenicity to isoechogenicity (P < 0.05). The percentage of expanded pelves increased with hydration (T0: 3.2%, T30: 9.7%, T60: 22.6%).


Oral hydration influences renal length, volume and echogenicity in children. Hydration results in expansion of the pelvis. We recommend standardisation of hydration before US examination.


Renal measurements Renal echogenicity Hydration Ultrasound Children 


Conflicts of interest

We declare that this study has been conducted without funds or grants and that we have no conflict of interest.


  1. 1.
    Bakker J, Olree M, Kaatee R et al (1999) Renal volume measurements: accuracy and repeatability of US compared with that of MR imaging. Radiology 211:623–628PubMedCrossRefGoogle Scholar
  2. 2.
    Kraus RA, Gaisie G, Young LW (1990) Increased renal parenchymal echogenicity: causes in pediatric patients. Radiographics 10:1009–1018PubMedCrossRefGoogle Scholar
  3. 3.
    Quaia E, Bertolotto M (2002) Renal parenchymal diseases: is characterization feasible with ultrasound? Eur Radiol 12:2006–2020PubMedGoogle Scholar
  4. 4.
    Kantarci F, Mihmanli I, Adaletli I et al (2006) The effect of fluid intake on renal length measurement in adults. J Clin Ultrasound 34:128–133PubMedCrossRefGoogle Scholar
  5. 5.
    Er A, Aydin B, Nayir T (2008) Does hydration matter in ultrasound measurement of renal lengths in children? Pediatr Nephrol 23:1371–1372PubMedCrossRefGoogle Scholar
  6. 6.
    Manley JA, O’Neill WC (2001) How echogenic is echogenic? Quantitative acoustics of the renal cortex. Am J Kidney Dis 37:706–711PubMedCrossRefGoogle Scholar
  7. 7.
    Schmidt IM, Main KM, Damgaard IN et al (2004) Kidney growth in 717 healthy children aged 0–18 months: a longitudinal cohort study. Pediatr Nephrol 19:992–1003PubMedGoogle Scholar
  8. 8.
    Emamian SA, Nielsen MB, Pedersen JF et al (1993) Kidney dimensions at sonography: correlation with age, sex, and habitus in 665 adult volunteers. AJR Am J Roentgenol 160:83–86PubMedCrossRefGoogle Scholar
  9. 9.
    Kadioglu A (2010) Renal measurements, including length, parenchymal thickness, and medullary pyramid thickness, in healthy children: what are the normative ultrasound values? AJR Am J Roentgenol 194:509–515PubMedCrossRefGoogle Scholar
  10. 10.
    Seeley R, Stephens T, Tate P (2000) Anatomy & physiology, 5th edn. McGraw-Hill, Boston, pp 884–888Google Scholar
  11. 11.
    Jordan J (2002) Acute effect of water on blood pressure. What do we know? Clin Auton Res 12:250–255PubMedCrossRefGoogle Scholar
  12. 12.
    Absy M, Metreweli C, Matthews C et al (1987) Changes in transplanted kidney volume measured by ultrasound. Br J Radiol 60:525–529PubMedCrossRefGoogle Scholar
  13. 13.
    Adibi A, Adibi I, Khosravi P (2007) Do kidney sizes in ultrasonography correlate to glomerular filtration rate in healthy children? Australas Radiol 51:555–559PubMedCrossRefGoogle Scholar
  14. 14.
    Riccabona M, Avni FE, Blickman JG et al (2008) Imaging recommendations in paediatric uroradiology: minutes of the ESPR workgroup session on urinary tract infection, fetal hydronephrosis, urinary tract ultrasonography and voiding cystourethrography, Barcelona, Spain, June 2007. Pediatr Radiol 38:138–145PubMedCrossRefGoogle Scholar
  15. 15.
    Akgun V, Kocaoglu M, Ilgan S et al (2010) Diuretic-induced renal length changes in the estimation of renal function with MR urography. AJR Am J Roentgenol 194:218–220CrossRefGoogle Scholar
  16. 16.
    Han BK, Babcock DS (1985) Sonofigure measurements and appearance of normal kidneys in children. AJR Am J Roentgenol 145:611–616PubMedCrossRefGoogle Scholar
  17. 17.
    Krensky AM, Reddish JM, Teele RL (1983) Causes of increased renal echogenicity in pediatric patients. Pediatrics 72:840–846PubMedGoogle Scholar
  18. 18.
    Wiersma F, Toorenvliet BR, Ruige M et al (2008) Increased echogenicity of renal cortex: a transient feature in acutely ill children. AJR Am J Roentgenol 190:240–243PubMedCrossRefGoogle Scholar
  19. 19.
    Masson P, De Luca G, Tapia N et al (2009) Postnatal investigation and outcome of isolated fetal renal pelvis dilatation. Arch Pediatr 16:1103–1110PubMedCrossRefGoogle Scholar
  20. 20.
    Riccabona M, Avni FE, Blickman JG et al (2009) Imaging recommendations in paediatric uroradiology. Minutes of the ESPR uroradiology task force session on childhood obstructive uropathy, high-grade fetal hydronephrosis, childhood haematuria, and urolithiasis in childhood. ESPR Annual Congress, Edinburgh, UK, June 2008. Pediatr Radiol 39:891–898PubMedCrossRefGoogle Scholar
  21. 21.
    Hasch E (1977) Changes in renal pelvic size in children after fluid intake demonstrated by ultrasound. Ultrasound Med Biol 2:287–290PubMedCrossRefGoogle Scholar
  22. 22.
    Hvarness H, Jakobsen H, Hermansen F et al (1999) Effect of a full bladder on urine production in humans. Scand J Urol Nephrol 33:386–391PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Mooneera Peerboccus
    • 1
  • Nasroolla Damry
    • 1
  • Sanjiva Pather
    • 1
  • Arnaud Devriendt
    • 1
  • Freddy Avni
    • 1
  1. 1.Radiology DepartmentHôpital Universitaire des Enfants, Reine FabiolaBrusselsBelgium

Personalised recommendations