Abstract
BackgroundMen have larger kidneys than women, but it is unclear whether gender remains an independent predictor of kidney size (expressed as weight or length) after correction for body size. We analysed autopsy data to assess whether relative renal length and weight (e.g. corrected for body weight, height or body surface area (BSA)) are also larger in men. Assuming that kidney size is associated with nephron number, opposite findings could partly explain why women are less prone to the development and progression of chronic kidney disease than men.MethodsAll forensic autopsies performed between 2009 and 2015 at the local university hospital of Geneva in individuals of European descent aged ≥18 years without a known history of diabetes and/or kidney disease were examined. Individuals with putrefied or severely injured bodies were excluded. Relative renal weight and length were respectively defined as renal weight divided by body weight or BSA and renal length divided by body height or BSA.ResultsA total of 635 autopsies (68.7% men) were included in the analysis. Left kidneys were on average 8 g heavier and 2 mm longer than right kidneys (both: p < 0.05). Absolute renal weight (165 ± 40 vs 122 ± 29 g) and length (12.0 ± 1.3 vs 11.4 ± 1.1 cm) were higher in men. Relative renal weight was also higher in men, but relative renal length was larger in women. In multivariable regression analysis, body height, body weight, the degree of blood congestion or depletion at autopsy and age were determinants of renal weight, whereas arterial hypertension and smoking were not. Percentile curves of renal weight and length according to sex and body height were constructed.ConclusionAbsolute and relative renal weights were both smaller in women. This is in line with recent studies stating that nephron numbers are also lower in women. Relative renal length was longer in women, suggesting that female kidneys have a more elongated shape. In comparison with older autopsy studies, renal weight appears to be stable over time.
Highlights
Men have larger kidneys than women, but it is unclear whether gender remains an independent predictor of kidney size after correction for body size
Cohorts of Chronic kidney disease (CKD) patients have shown that men with CKD progress faster to end stage renal disease (ESRD) than women [7], suggesting that intrinsic renal differences exist between men and women
Autopsies performed in adults of European descent (Caucasians) aged 18 and above whose deaths were sudden, unexpected or violent, or for which the cause of death was not considered as natural by the attending physician could be included in the analysis
Summary
Men have larger kidneys than women, but it is unclear whether gender remains an independent predictor of kidney size (expressed as weight or length) after correction for body size. Assuming that kidney size is associated with nephron number, opposite findings could partly explain why women are less prone to the development and progression of chronic kidney disease than men. There is an ongoing debate on the question whether women are less prone to develop and progress CKD than men. In this context, many (but not all) studies have reported a higher prevalence of CKD in men, especially before the age of 60 [3]. In a recent worldwide survey, the age-standardized prevalence of arterial hypertension in adults was higher in men: 24% versus 20% in women [4]. Cohorts of CKD patients have shown that men with CKD progress faster to end stage renal disease (ESRD) than women [7], suggesting that intrinsic renal differences exist between men and women
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