Abstract
Malnutrition is a widespread disorder in children, and ultrasonography is the method of choice to estimate kidney dimensions. Previously, kidney sizes had been studied in healthy newborns and in pediatric patients; however, kidney sizes were not investigated sufficiently in malnourished children. The study group consisted of 74 children with energy malnutrition (marasmus), and the control group consisted of 47 healthy children. Kidney sizes were mesaured by the same radiologist using ultrasonography. The mean age of the marasmic group was 29.6 ± 14.0 months. Malnourished children had significantly lower kidney length and renal volume but higher relative kidney volume (cm3/body weight) compared with controls (P < 0.05). The mean length and volume of left kidney were higher than those of right kidney in both marasmic and control groups (P < 0.05). The strongest positive correlations were found between body height and kidney length, depth and volume in marasmic group. Regression analysis revealed that height and age of marasmic children had a significant effect on kidney volume; however, only body height had an effect on kidney length. In conclusion, malnourished children had smaller kidney sizes, and body height was the main determinant of their kidney length and volume. The potential long-term detrimental consequences of poor renal growth in malnutrition need to be investigated.
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Sawaya AL, Martins PA, Grillo LP, Florencio TT (2004) Long-term effects of early malnutrition on body weight regulation. Nutr Rev 62:S127–S133
Cunningham-Rundles S, McNeeley DF, Moon A (2005) Mechanisms of nutrient modulation of the immune response. J Allergy Clin Immunol 115:1119–1128
Schmidt I, Chellakooty M, Boisen KA, Damgaard IN, Kai CM, Olgaard K, Main KM (2005) Impaired kidney growth in low-birth-weight children: Distinct effects of maturity and weight for gestational age. Kidney Int 68:731–740
Gado RD, Perrone L, Del Gaizo D, Sommantico M, Polidori G, Cioce F, Rambaldi PF, Sirigu A (2003) Renal size and function in patients with neuropathic bladder due to myelomeningocele: the role of growth hormone. J Urol 170:1960–1961
Schmidt IM, Damgaard IN, Boisen KA, Mau C, Chellakooty M, Olgaard K, Main KM (2004) Increased kidney growth in formula-fed versus breast-fed healthy infants. Pediatr Nephrol 19:1137–1144
Schmidt IM, Molgaard C, Main KM, Michaelsen KF (2001) Effect of gender and lean body mass on kidney size in healthy 10-year-old children. Pediatr Nephrol 16:366–370
Morrison EY, Alleyne GA (1976) Malnutrition, kidney size and composition. Arch Latinoam Nutr 26:7–14
Hoy WE, Douglas-Denton RN, Hughson MD, Cass A, Johnson K, Bertram JF (2003) A stereological study of glomerular number and volume: Preliminary findings in a multiracial study of kidneys at autopsy. Kidney Int Suppl 83:S31–S37
Brenner BM, Mackenzie HS (1997) Nephron mass as a risk factor for progression of renal disease. Kidney Int Suppl 63:S124–S127
Singh GR, Hoy WE (2004) Kidney volume, blood pressure, and albuminuria: findings in an Australian Aboriginal community. Am J Kidney Dis 43:254–259
Wellcome Trust Working Party (1970) Classification of infantile malnutrition. Lancet ii:302–306
Hamill P, Drizd T, Johnson C, Reed RB, Roche AF, Moore WM (1979) Physical growth: National Center for Health Statistics Percentiles. Am J Clin Nutr 32:607–629
Zenkl M, Egghart G, Muller M (1990) The normal kidney size in children. An ultrasound study. Urologe A 29:32–38
Du Bois D, Du Bois EF (1916) A formula to estimate the approximate surface area if height and weight be known. Arch Intern Med 17:863–871
Kasiske BL, Umen AJ (1986) The influence of age, sex, race, and body habitus on kidney weight in humans. Arch Pathol Lab Med 110:55–60
Jelen Z (1993) The value of ultrasonography as a screening procedure of the neonatal urinary tract: a survey of 1021 infants. Int Urol Nephrol 25:3–10
Han BK, Babcock DS (1985) Sonographic measurements and appearance of normal kidneys in children. AJR Am J Roentgenol 145:611–616
Holloway H, Jones TB, Robinson AE, Harpen MD, Wiseman HJ (1983) Sonographic determination of renal volumes in normal neonates. Pediatr Radiol 13:212–214
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
Chiara A, Chirico G, Barbarini M, De Vecchi E, Rondini G (1989) Ultrasonic evaluation of kidney length in term and preterm infants. Eur J Pediatr 149:94–95
Emamian SA, Nielsen MB, Pedersen JF, Ytte L (1993) Kidney dimensions at sonography: correlation with age, sex, and habitus in 665 adult volunteers. AJR Am J Roentgenol 160:83–86
Haugstvedt S, Lundberg J (1980) Kidney size in normal children measured by sonography. Scand J Urol Nephrol 14:251–255
Dremsek PA, Kritscher H, Böhm G, Hochberger O (1987) Kidney dimensions in ultrasound compared to somatometric parameters in normal children. Pediatr Radiol 17:285–290
Konus 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. AJR Am J Roentgenol 171:1693–1698
Fitzsimons RB (1983) Kidney length in the newborn measured by ultrasound. Acta Paediatr Scand 72:885–887
Scott JE, Hunter EW, Lee RE, Matthews JN (1990) Ultrasound measurement of renal size in newborn infants. Arch Dis Child 65:361–364
Miletic D, Fuckar Z, Sustic A, Mozetic V, Stimac D, Zauhar G (1998) Sonographic measurement of absolute and relative renal length in adults. J Clin Ultrasound 26:185–189
Schmidt IM, Main KM, Damgaard IN, Mau C, Haavisto AM, Chellakooty M, Boisen KM, Petersen JH, Scheike T, Olgaard K (2004) Kidney growth in 717 healthy children aged 0–18 months: a longitudinal cohort study. Pediatr Nephrol 19:992–1003
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We thank Dr. Fuat Gürkan, M.D. for his contribution in editing the manuscript.
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Ece, A., Gözü, A., Bükte, Y. et al. The effect of malnutrition on kidney size in children. Pediatr Nephrol 22, 857–863 (2007). https://doi.org/10.1007/s00467-006-0338-5
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DOI: https://doi.org/10.1007/s00467-006-0338-5