Abstract
Background
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.
Methods
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.
Results
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.
Conclusions
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.
Graphical abstract
A higher resolution version of the Graphical abstract is available as Supplementary information
Similar content being viewed by others
Abbreviations
- eGFR:
-
Estimated glomerular filtration rate
- BSA:
-
Body surface area
- BMI:
-
Body mass index
- GFR:
-
Glomerular filtration rate
- LMS:
-
Lambda-mu-sigma
- USG:
-
Ultrasonography
References
Rosenbaum DM, Korngold E, Teele RL (1984) Sonographic assessment of renal length in normal children. Am J Roentgenol 142:467–469
Obrycki Ł, Sarnecki J, Lichosik M et al (2021) Kidney length normative values in children aged 0–19 years - a multicenter study. Pediatr Nephrol 37:1075–1085
Haycock GB, Schwartz GJ, Wisotsky DH (1978) Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults. J Pediatr 93:62–66
Schwartz GJ, Muñoz A, Schneider MF, Mak RH, Kaskel F, Warady BA, Furth SL (2009) New equations to estimate GFR in children with CKD. J Am Soc Nephrol 20:629–637
Cole TJ (1988) Using the LMS method to measure skewness in the NCHS and Dutch National height standards. Ann Hum Biol 16:407–419
Coombs PR, Lavender I, Leung MYZ, Woods JC, Paul E, Webb N, Ditchfield M (2019) Normal sonographic renal length measurements in an Australian pediatric population. Pediatr Radiol 49:1754–1761
Vujic A, Kosutic J, Bogdanovic R, Prijic S, Milicic B, Igrutinovic Z (2007) Sonographic assessment of normal kidney dimensions in the first year of life–a study of 992 healthy infants. Pediatr Nephrol 22:1143–1150
Konuş OL, Ozdemir A, Akkaya A, Erbas G, Celik H, Isik S (1998) Normal liver, spleen, and kidney dimensions in neonates, infants, and children: evaluation with sonography. Am J Roentgenol 171:1693–1698
Thapa NB, Shah S, Pradhan A, Rijal K, Pradhan A, Basnet S (2015) Sonographic assessment of the normal dimensions of liver, spleen, and kidney in healthy children at tertiary care hospital. Kathmandu Univ Med J 13:286–291
Dinkel E, Ertel M, Dittrich M, Peters H, Berres M, Schulte-Wissermann H (1985) Kidney size in childhood. Sonographical growth charts for kidney length and volume. Pediatr Radiol 15:38–43
Moskowitz PS, Carroll BA, McCoy JM (1980) Ultrasonic renal volumetry in children: accuracy and simplicity of the method. Radiology 134:61–64
Holloway H, Jones TB, Robinson AE, Harpen MD, Wiseman HJ (1983) Sonographic determination of renal volumes in normal neonates. Pediatr Radiol 13:212–214
Jones TB, Riddick LR, Harpen MD, Dubuisson RL, Samuels D (1983) Ultrasonographic determination of renal mass and renal volume. J Ultrasound Med 2:151–154
Acknowledgements
We thank all of the parents and children from kindergartens and schools in Warsaw, Gniewkowo, Toruń, and Inowrocław, for their participation in the research.
Funding
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.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no competing interests.
Additional information
Publisher's note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Graphical abstract
(PPTX 291 kb)
ESM 1
Supplementary Figure S1 Kidney length percentiles by weight in boys (PNG 280 kb)
ESM 2
Supplementary Figure S2 Kidney length percentiles by weight in girls (PNG 254 kb)
Rights and permissions
Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
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
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00467-022-05667-2