Kidney size evaluation is an essential examination in pediatric nephrology. While body length/height is the best predictor of kidney length, age-based and body surface area (BSA)–based normative values may be useful in clinical practice or research. This study aimed to establish ultrasound-based kidney length lambda-mu-sigma (LMS) percentiles by age and BSA in healthy children.
In 1758 Polish and Lithuanian children (868 boys, 49%) aged 0–19 years, kidney length was measured using ultrasonography. In all participants, anthropometric measurements were taken and kidney function was evaluated based on serum creatinine concentration. Participants with chronic or kidney diseases, abnormal kidney function, or pathologies in sonographic examination were excluded from the analysis.
Kidney length (median kidney length) increased progressively from infancy to the age of 18 years, from 60.1 to 114.2 mm in males, and from 57.3 to 105.2 mm in females. A gradual increase of kidney length (50th percentile) in relation to BSA (from 46.1 mm in infants with a BSA of 0–1.2 m2 to 118.3 mm in adolescents with a BSA of 2.6–2.8 m2) was also observed. LMS percentiles by age (stratified by sex) and BSA were determined and presented as graphs and tables of percentiles and LMS parameters by 1-year age intervals and 0.2 m2 of BSA, respectively.
We present the first age- and BSA-based kidney length LMS normative values based on the largest pediatric cohort to date, which can be used in both clinical practice and research studies.
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Estimated glomerular filtration rate
Body surface area
Body mass index
Glomerular filtration rate
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We thank all of the parents and children from kindergartens and schools in Warsaw, Gniewkowo, Toruń, and Inowrocław, for their participation in the research.
The study was funded by The Children’s Memorial Health Institute intramural grant S165/18. The funder had no role in the design and conduct of the study.
Conflict of interest
The authors declare no competing interests.
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Supplementary Figure S1 Kidney length percentiles by weight in boys (PNG 280 kb)
Supplementary Figure S2 Kidney length percentiles by weight in girls (PNG 254 kb)
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Obrycki, Ł., Sarnecki, J., Lichosik, M. et al. Kidney length normative values — new percentiles by age and body surface area in Central European children and adolescents. Pediatr Nephrol 38, 1187–1193 (2023). https://doi.org/10.1007/s00467-022-05667-2