Associations of MRI-derived kidney volume, kidney function, body composition and physical performance in ≈38000 UK Biobank participants: a population-based observational study.

Abstract

Kidney volume is used as a predictive and therapeutic marker for several clinical conditions. However, there is a lack of large-scale studies examining the relationship between kidney volume and various clinicodemographic factors, including kidney function, body composition and physical performance. In this observational study, MRI-derived kidney volume measurements from 38526 UK Biobank participants were analysed. Major kidney volume-related measures included body surface area (BSA)-adjusted total kidney volume (TKV) and the difference in bilateral kidneys. Multivariable-adjusted linear regression and cubic spline analyses were used to explore the association between kidney volume-related measures and clinicodemographic factors. Cox or logistic regression was used to identify the risks of death, non-kidney cancer, myocardial infarction, ischaemic stroke and chronic kidney disease (CKD). The median of BSA-adjusted TKV and the difference in kidney volume were 141.9ml/m2 [interquartile range (IQR) 128.1-156.9] and 1.08-fold (IQR 1.04-1.15), respectively. Higher BSA-adjusted TKV was significantly associated with higher estimated glomerular filtration rate {eGFR; β=0.43 [95% confidence interval (CI) 0.42-0.44]; P<.001}, greater muscle volume [β=0.50 (95% CI 0.48-0.51); P<.001] and greater mean handgrip strength [β=0.15 (95% CI 0.13-0.16); P<.001] but lower visceral adipose tissue volume [VAT; β=-0.09 (95% CI -0.11 to -0.07); P<.001] in adjusted models. A greater difference in bilateral kidney volumes was associated with lower eGFR, muscle volume and physical performance but with higher proteinuria and VAT. Higher BSA-adjusted TKV was significantly associated with a reduced risk of CKD [odds ratio (OR) 0.7 (95% CI 0.63-0.77); P<.001], while a greater difference in kidney volume was significantly associated with an increased risk of CKD [OR 1.13 (95% CI 1.07-1.20); P<.001]. Higher BSA-adjusted TKV and lower differences in bilateral kidney volumes are associated with higher kidney function, muscle volume and physical performance and a reduced risk of CKD.