Abstract
ABSTRACTObjective:To evaluate the renal parenchymal area in human fetuses, providing a descriptive analysis on the renal area development by demographic factors during the second gestational trimester.Material and Methods:We analyzed 84 fetuses (44 males and 40 females), for a total of 168 renal units evaluated in terms of longitudinal length, superior pole width, inferior pole width and thickness. Renal volume was calculated by ellipsoid formula. After renal pelvis dissection, length and width were evaluated; as pelvis is free of urine, we considered thickness as 1mm. Renal pelvis volume was also calculated by ellipsoid formula. Renal parenchymal area was assessed by excluding the volume of the renal pelvis from the total renal volume. We performed the statistical analysis by simple linear regression assessing the association between the variables analyzed with the fetal age.Results:Gestational age ranged from 12 to 23 weeks post conception. Mean renal parenchymal area of the right kidney was 666.22mm3 (45.86 to 2375.35mm3) and for the left kidney was 606.76mm3 (68.63 to 2402.57mm3). No statistical difference was observed between the sides (p-value = 0.3456) or genders (p-value = 0.07429). Linear regression between renal parenchymal volume and gestational age was positive for right kidney (y = 133.74x-1479.94 / r2 = 0.4009) and left kidney (y = 149.53x-1761.59 / r2 = 0.4591).Conclusions:The linear regression analysis indicated that renal parenchymal area correlated significantly and positively with fetal age, weight and crown-rump length with no statistical differences between gender or laterality. These growth curves provide a reference for functional volume of the kidney during fetal period.
Highlights
The objective of this paper is to evaluate the renal parenchymal volume in human fetuses, providing a descriptive analysis on the renal parenchymal area development by demographic factors during the second gestational trimester, to provide standard values for prenatal hydronephrosis evaluation during US
Since the pelvis was free of urine in the fetuses analyzed, we considered the thickness of the renal pelvis as 1mm, to the fetal renal pelvis volume was calculated using the ellipsoid formula too: fetal renal pelvis volume (RpvV) = renal pelvis length x renal pelvis thickness (= 1mm) x renal pelvis width x 0.523
The summary of the findings regarding the volume of the kidneys, pelvis and parenchyma for each gender and sides are shown in Table-2
Summary
This study was carried out in accordance with the ethical standards of the hospital’s institutional committee on human experimentation. We studied 84 fresh human fetuses (44 males and 40 females) ranging in age from 12 to 23 weeks post-conception (WPC), during the period from January 2016 through August 2017, for a total of 168 kidneys. The fetuses were macroscopically well preserved, showed no signs of malformations and the demise was hypoxia. The gestational age was determined in WPC according to the foot-length criterion. This criterion is currently considered the most acceptable parameter to estimate gestational age [14,15,16]. All the kidneys with anomalies (fusion, rotation, duplication) and renal pelvis dilation were excluded from the study
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