Abstract
Quantitative measurements of renal echogenicity using a graphic program show close correlation with renal histology in adult patients, but this has neither been applied in pediatric patients nor correlated with glomerular filtration rate (GFR). To determine the direct relationship between echogenicity and GFR, we retrospectively analyzed 91 patients with a solitary functioning kidney under the age of 10, who underwent ultrasonography and serum cystatin C evaluation on a single day between January 2013 and December 2014. Echogenicity was quantified as previously reported. Echogenicity and kidney length were correlated with age-matched values of serum cystatin C-based GFR. Evaluation was performed at a median age of 17.1 months. GFR was low for age in eight of 54 right solitary kidney patients and four of 37 left solitary kidney patients. The right kidney-liver ratio was significantly elevated in the right decreased GFR group, while the left kidney-spleen ratio was not different in the left decreased GFR group. Age-matched longitudinal kidney length ratios were similar between the decreased and normal GFR groups for both sides. This is the first report to objectively prove the relationship between echogenicity and renal function in patients with a right solitary kidney. The right kidney-liver echogenicity ratio, measured objectively, showed feasibility in clinical practice as it showed a close relationship with decreased renal function when increased. However, absolute kidney echogenicity values, or the left kidney-spleen echogenicity ratio, were not independent markers for decreased renal function.
Highlights
Ultrasonography is the fundamental imaging modality in daily pediatric urological practice
Ultrasonography was performed and serum cystatin C evaluated at a median age of 17.1 months
Among the 54 patients with right solitary kidneys, glomerular filtration rate (GFR) was decreased in eight right solitary kidney patients (14.8%) for their age (Table 3)
Summary
Ultrasonography is the fundamental imaging modality in daily pediatric urological practice. The existence of hydronephrosis, longitudinal kidney length, corticomedullary differentiation, and cortical thickness are all known important parameters in the analysis of pediatric renal
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