Mean Kidney Length Research Articles

Kidney Dimensions and its Correlation with Anthropometric Parameters in Healthy North Indian Adults.

Knowledge of kidney size is important in the assessment of kidney function. Changes in kidney size can occur in various kidney diseases due to different causes, hence knowledge of normal kidney dimensions in a population is crucial for diagnosis, follow-up and prognostication. While data from other parts of the world does not apply to the Indian population due to differences in ethnicity, diet and body sizes, and there is also a lack of standardized data on normal kidney sizes in healthy Indian adults. Kidney dimensions from 600 healthy adult volunteers ranging between 20 and 70 years of age were measured with sonography by a single radiologist. Differences in dimensions between men and women, and right and left kidney were analyzed. Finally, kidney sizes were correlated with anthropometric variables such as weight, age, body surface area (BSA), height and body mass index. Estimated glomerular filtration rate (eGFR) was correlated with kidney length and renal parenchymal volume (RPV). The mean kidney length of the whole cohort, irrespective of gender was found to be 9.6 ± 0.7 cm on the right and 9.9 ± 0.7 cm on the left. Mean kidney length in males was significantly more as compared to females on both sides. Both the kidney length and RPV were significantly associated with BSA, weight and height (in that order) in females, whereas in males, kidney length and RPV best correlated with height, BSA and weight (in that order). In both sexes, there was a significant negative correlation between age and kidney length, RPV. eGFR had a significant positive correlation with kidney length and RPV in the cohort. Normal sonographic mean kidney length was 9.6±0.7 cm and 9.9±0.7 cm on the right and left sides respectively in healthy North Indian population, with the left kidney being larger than the right in all dimensions (length, width, thickness and RPV). Kidney sizes in males were found to be larger than females. Correlation with anthropometric parameters in our study, emphasizes the need to give due consideration to normal variations in kidney sizes with age, gender, height, weight and BSA to differentiate between a normal and a pathologically small or large kidney.

Renal transplants increase in size and function in keeping with compensatory renal hypertrophy.

To evaluate changes in allograft kidney length in renal transplant recipients and the relationship with estimated glomerular filtration rate (eGFR). This single-centre retrospective study of renal transplant recipients was conducted at Flinders Medical Centre (FMC) from January 2007 to June 2020. Donor and recipient details, renal allograft length from transplant ultrasounds at 0, 1, 3, 6 and 12 months were collected. The association between compensatory renal hypertrophy (CRH) and eGFR and its magnitude was analysed using multivariate multilevel mixed-effects linear regression models. A total of 183 renal transplant recipients were studied. 100 of 175 recipients (62.9%) demonstrated an increase in renal length defined as any increase in maximal longitudinal diameter on serial ultrasounds. Twenty-three recipients (13.1%) had no change in transplant length and 42 recipients (24%) had a decrease in length. The mean increase in kidney length over the first 12 months was 0.57 cm. Ninety of 156 (57.7%) recipients with a renal ultrasound within a month post-transplant demonstrated a mean increase kidney length of 0.3 cm. Multivariate analysis demonstrated that eGFR increased by 2.5 mL/min/1.73 m2 (95% CI 0.72- 4.4; p = .006) with every 1 cm increase in kidney length. Absolute changes in kidney length did not demonstrate any statistically significant correlation with eGFR in both complete case and multiple imputation analysis. An increase in transplant kidney length is common in renal transplant recipients and is associated with enhanced eGFR. However, further studies need to be performed to study the association of absolute change in kidney length and eGFR.

Combining genotype with height-adjusted kidney length predicts rapid progression of ADPKD.

Our main objective was to identify baseline prognostic factors predictive of rapid disease progression in a large unselected clinical autosomal dominant polycystic kidney disease (ADPKD) cohort. A cross-sectional analysis was performed in 618 consecutive ADPKD patients assessed and followed-up for over a decade. A total of 123 patients (19.9%) had reached kidney failure by the study date. Data were available for the following: baseline eGFR (n=501), genotype (n=549), baseline ultrasound mean kidney length (MKL, n=424) and height-adjusted baseline MKL (HtMKL, n=377). Rapid disease progression was defined as an annualized eGFR decline (∆eGFR) of >2.5mL/min/year by linear regression over 5years (n=158). Patients were further divided into slow, rapid and very rapid ∆eGFR classes for analysis. Genotyped patients were classified into several categories: PKD1 (T, truncating; or NT, non-truncating), PKD2, other genes (non-PKD1 or -PKD2), no mutation detected or variants of uncertain significance. A PKD1-T genotype had the strongest influence on the probability of reduced baseline kidney function by age. A multivariate logistic regression model identified PKD1-T genotype and HtMKL (>9.5cm/m) as independent predictors for rapid disease progression. The combination of both factors increased the positive predictive value for rapid disease progression over age 40years and of reaching kidney failure by age 60years to 100%. Exploratory analysis in a subgroup with available total kidney volumes showed higher positive predictive value (100% vs 80%) and negative predictive value (42% vs 33%) in predicting rapid disease progression compared with the Mayo Imaging Classification (1C-E). Real-world longitudinal data confirm the importance of genotype and kidney length as independent variables determining ∆eGFR. Individuals with the highest risk of rapid disease progression can be positively selected for treatment based on this combination.

Sonographic Evaluation of Renal dimensions in a healthy adult Nigerian Population

Background: This study is on sonographic evaluation of renal dimensions in the healthy adult Nigerian population.
 Aim: The objective of the study was to determine normal dimensions of the kidney sonographically and to correlate the measurements with the sex, age, height, weight and body mass index, in the adult Nigerian population.
 Methodology: This was a prospective hospital based ultrasound study of five hundred (500) apparently healthy adults that were 20 years and above as at the time of data collection, Renal dimensions, length, width and cortical renal thickness were measured. A questionnaire was used for inclusion and exclusion criteria. Consent was obtained from the individuals before the study and strict confidentiality was maintained. Descriptive and inferential statistics were deployed to realize the objectives. The data was analyzed using SPSS statistical package version 20.0. The mean, median, variance, standard deviation of the kidney sizes were evaluated and correlated with the age, sex, weight, height and body mass index of the subjects.
 Result: The mean right kidney length measured 94.2+8mm for male and 91.8+9mm for females with a range of 64.0-113mm and 76.0-123mm for males and female respectively. The left mean kidney length measured 99.4+8.1mm and 95.5+9.5mm with a range of 76.0-119.0mm and 76.0-114.mm for males and females respectively while the width was 40.7±3.4mm for males and 40.5±3.4mm for females with P values of 0.599mm which is not significant. Mean left kidney width was 44.7±5.8mm for males and 44.5±9.5mm for females with ranges of 33.0-65.0mm and 30.0-61.0mm for males and females respectively with P values of 0.719 which is not significant. Males had a mean renal cortical thickness of 18.3±2.9mm while females had 16.6±2.9mm with P values of 0.000.
 Conclusion: The renal cortical thickness in males is greater than in females. The left cortical renal thickness is greater than the right. There is positive correlation of the left cortical renal thickness with age, but not with body mass index and height. Males have greater kidney length than females but the differences in length are not significant. Also, Males have greater kidney width than females. When correlated with age, height, weight and body mass index of the subjects.

Comparison of Foetal Kidney Length with foetal Biometric Parameters (Biparietal Diameter, Abdominal Circumference, Head Circumference and Femur Length) in the Third Trimester of Pregnancy

Introduction: The basis for an obstetrician's capacity to successfully organise an intervention, administer prenatal care, and conduct prenatal testing. exact awareness of the gestational age. This study conducted to find out correlation of foetal kidney length with foetal biometric parameters like BPD, AC, HC and FL in the third trimester of pregnancy
 Methodology: A cross-sectional observational research was carried out on third-trimester pregnant patients who were seen in the obstetrics and gynaecology outpatient department at a tertiary care hospital in India. The study included all women who were singleton pregnant in the third trimester (28 to 40 weeks), had date scans that were documented, were certain of their last menstrual cycle, had a normal prenatal period, and had no risk factors connected with them.
 Results: A reasonably excellent positive correlation between MKL and GA. With a decent fit and a R squared (R2) value of 0.599. There is a reasonably strong positive correlation (r) between MKL and GA by HC. With a decent fit and a R squared (R2) value of 0.545, this regression model explains 54.5 percent of changes in GA by HC with MKL. According to the Pearson Association Coefficient (r), there is a relatively strong positive correlation (r) between MKL and GA via AC. A high positive correlation (very good) between MKL and GA via FL. With a decent fit and a R squared (R2) value of 0.668, this regression model explains 66.8% of changes in GA by FL with MKL.
 Conclusion: That there is a high correlation between the mean kidney length of the foetus and established biometric markers of gestational age, including femur length, head size, belly circumference, and biparietal diameter.

DETERMINING THE GESTATIONAL USING FOETAL KIDNEY LENGTH DURING THIRD TRIMESTER PREGNANCY IN INDIAN POPULATION

Introduction: Although fetal biometry measurements aid in an accurate estimation of GA in the early second trimester, the biological variations of size lead to these parameters' accuracy to vary as the age of the fetus advanced, making it challenging to date a fetus accurately in the late second or third trimester. Therefore, this study conducted to assess correlation of foetal kidney length with gestational age in third trimester of pregnancy. Methodology: This was a cross-sectional observational study conducted among 120 pregnant women in the 3rd trimester. For obtaining foetal kidney length, longitudinal section was taken in sagittal plane using ultrasound. Results: Out of total 120 cases, the left kidney length (LKL) is slightly higher than the right kidney length (RKL). Mean kidney lengths (MKL) rose consist-ently with gestational age, from 27.18 ± 2.2O mm at 28 weeks to З8.O ± l.8O mm at З9 weeks. RKL, LKL and MKL were positively correlated with gestational age. R squared (R2) value was 0.769 which is a good fit and indicates that this regression model explains 76.9% changes in GA with MKL. Conclusion: Foetal kidney length is a reliable measure of gestational age. Measuring the foetal mean kidney length using ultrasound is a simple tech-nique to determine the gestational age. In third trimester pregnancy with un-certain LMP, the length of the foetal kidneys may be extremely helpful in de-termining gestational age.

Outcomes of percutaneous transluminal renal angioplasty for pediatric renovascular hypertension: a 12-year retrospective single-center experience.

Renovascular disease underlies 5-10% of all childhood hypertension. We evaluated the long-term outcomes of percutaneous transluminal renal angioplasty (PTRA) for pediatric renovascular hypertension (RVH). Data from 37 children with RVH who underwent PTRA of 45 lesions at our center from January 2010 to January 2022 were retrospectively evaluated. Postoperative blood pressure (BP), glomerular filtration rate (GFR), affected kidney size, restenosis, and complications were analyzed. Mean age, weight, and height of patients at first PTRA was 11.51±4.57 (range, 3-17) years, 45.37±22.29 (range, 13.40-106.00) kg, and 1.46±0.26 (range, 0.92-1.85) m, respectively. Technical success was achieved in 33 of 37 (89.2%) patients and 40 of 45 (88.9%) lesions, without surgery-related complications. At a median of 7.5 (range, 3-14) months, restenosis occurred in 6 (16.7%) patients and 7 (16.3%) lesions (all ostial and 6 with a length >15 mm), yielding a clinical beneficial rate from first PTRA of 83.3%. At 18- and 20-month follow-up the mean kidney length (29 kidneys) increased from 8.89±1.55 to 9.79±1.51 cm (P<0.001) and mean GFR (34 kidneys) from 32.28±19.22 to 41.24±13.24 mL/min (P<0.001). In this retrospective analysis, PTRA for the treatment of pediatric RVH can achieve satisfactory results. Angioplasty was associated with improved BP control and long-term preservation of renal function, as reflected by an increase in affected kidney size and a higher GFR.

Ultrasound Measurement of Fetal Kidney Length in Normal Pregnancy and its Correlation with Gestational Age.

To establish a nomogram of fetal kidney length for a normal pregnancy from 20 to 41 weeks of gestational age. A prospective cross-sectional study was carried out in the Department of radio-diagnosis and imaging BPKIHS, Dharan. 400 kidneys of 200 fetuses between the gestational age 20 to 41 weeks were scanned. Renal measurement was performed by ultrasonography. Analysis was performed on data obtained from 200 normal fetuses. Size charts for right, left and mean fetal kidney length with standard deviation were presented for each weeks of gestation from 20 weeks to 41 weeks. The difference in renal length between right and left side was statistically not significant.There was significant correlation between gestational age and fetal kidney length (r=0.947, p=0.001). Fetal kidney length can be used as an adjunct parameter for estimation of gestation age.

Determination of Gestational Age by Fetal Kidney Length Measurement in Uncomplicated Pregnancy in a Tertiary Care Centre

Introsution: Gestational age of fetus is estimated by including various biometric parameters. Newer parameters like fetal kidney length have not been studied in Nepalese population.&#x0D; Objective: To determine gestational age by fetal kidney length measurement after the 20th week of gestation in healthy women with uncomplicated pregnancy.&#x0D; Method: Obstetric sonography was performed in 108 pregnant women with regular menstrual cycles, known menstrual age and uncomplicated pregnancy from 20 weeks to term. Fetal kidney length was evaluated as a measure to calculate the predicted gestational age.&#x0D; Results: The study showed mean fetal kidney length at 20-24, 25-29, 30-34 and 35-37 weeks gestation 22.5 ± 0.5, 26.9 ± 0.7, 32.32 ± 0.7 and 36.3 ± 0.6 mm, respectively. Overall, in second and third trimester, fetal kidney length showed strong linear correlation with gestation age with highest significant Pearson correlation coefficient of 0.989 as compared to other parameters (BPD=0.986, HC=0.976, AC= 0.971, FL= 0.984).&#x0D; Conclusion: Fetal kidney length can be used as a reliable parameter for determination of gestational age.

Ultrasound Measurement of Foetal Kidney Length during Healthy Pregnancy: Relationship with Gestational Age.

Foetal kidney length (FKL) measurements and comparisons to normal charts can be used to assess the development of the foetal kidneys throughout the entire course of pregnancy. This study was designed to assess FKL between 20 - 40 weeks' gestation, establish reference ranges for FKL and determine the relationship between FKL and gestational age (GA) in normal pregnancy. This descriptive, cross-sectional study was conducted between March-August 2022, at the Obstetric Units and Radiology Departments of the two tertiary health facilities, one secondary facility and one radio-diagnostic facility in Bayelsa State, Southern Nigeria. Transabdominal ultrasound scan was used to evaluate the foetal kidneys. The relationship between foetal kidney dimensions and GA was explored using Pearson's correlation analysis. Linear regression analysis was done to define the relationship between GA and mean kidney length (MKL). A nomogram predicting GA from MKL was constructed. Level of significance was set at p<0.05. There was a very strong significant correlation between foetal renal dimensions and GA. The correlation coefficient between GA and mean FKL, width and anteroposterior diameter were 0.89 (p=0.001), 0.87 (p=0.001) and 0.82 (p=0.001), respectively. A unit change in mean FKL corresponded to a 79% change in GA (ɼ2), showing a very strong association between mean FKL and GA. The regression equation: GA = 9.87 + 5.91 x MKL, was derived for estimation of GA for a given MKL. Our study revealed a significant relationship between FKL and GA. The FKL can therefore be reliably used to estimate GA.

Ultrasound measurement of fetal kidney length in the second and third trimester of pregnancy and its correlation with gestational age

Aims: To measure the fetal kidney length in the second and third trimesters of pregnancy and correlate it with the gestational age and other routine fetal parameters. Methods: This prospective cross-sectional study includes 250 pregnant women presented in the Nobel Medical College for ultrasound examination from the period of July 2021 to June 2022. Gestational age was estimated based on the last menstrual date and ultrasonogram. Routine fetal parameters and mean fetal kidney length were measured. The correlation between gestational age, fetal kidney length, and routine fetal parameters was studied. Results: The mean gestational age according to ultrasound and last menstrual period were 35.5 ± 3.4 weeks and 35.2 ± 3.2 weeks respectively. The mean fetal kidney length was 36.8 ± 4.02mm. There was a very strong positive correlation between gestational age and fetal kidney length (r=0.921, p =0.001). Compared to the routine fetal parameters, adding fetal kidney length improved the effectiveness in predicting gestational age. (R2 =0.918 vs. R2 =0.936) Conclusion: Fetal kidney length can be added to the other standard parameters to improve the prediction of gestational age.

Non-Invasive Evaluation of Kidney Elasticity and Viscosity in a Healthy Cohort.

Introduction:There is currently a lack of published data on kidney elasticity and viscosity. Non-invasive techniques, such as two-dimensional shear-wave elastography (2D-SWE PLUS) and viscosity plane-wave ultrasound (Vi PLUS), have surfaced as new detection methods, which, thanks to efficient processing software, are expected to improve renal stiffness and viscosity measurements. This study aims to be the first one to assess the normal range values in normal renal function subjects and to investigate the factors that impact them. Methods: We conducted a cross-sectional study employing 50 participants (29 women and 21 men) with a mean age of 42.22 ± 13.17, a mean estimated glomerular filtration rate (eGFR) of 97.12 ± 11 mL/min/1.73 m2, a mean kidney length of 10.16 ± 0.66 cm, and a mean body mass index (BMI) of 24.24 ± 3.98. With a C6-1X convex transducer and the Ultra-FastTM software available on the Hologic Aixplorer Mach 30 ultrasound system, we acquired five measurements of renal cortical stiffness and viscosity (achieved from five distinct images in the middle part of the subcapsular cortex) from each kidney. The ten measurements' median values correlated with the participant's demographical, biological, and clinical parameters. Results: The mean kidney elasticity was 31.88 ± 2.89 kiloPascal (kPa), and the mean viscosity was 2.44 ± 0.57 Pascal.second (Pa.s) for a mean measurement depth 4.58 ± 1.02cm. Renal stiffness seemed to be influenced by age (r = -0.7047, p &lt; 0.0001), the measurement depth (r = -0.3776, p = 0.0075), and eGFR (r = 0.6101,p &lt; 0.0001) but not by BMI (r = -0.2150, p = 0.1338), while viscosity appeared to be impacted by age (r= -0.4251, p = 0.0021), eGFR (r = 0.4057, p = 0.0038), the measurement depth (r= -0.4642, p = 0.0008), and BMI (r= -0.3676, p = 0.0086). The results of the one-way ANOVA used to test the differences in the variables among the three age sub-groups are statistically significant for both 2D-SWE PLUS (p &lt; 0.001) and Vi PLUS (p = 0.015). The method found good intra-operator reproducibility for the 2D-SWE PLUS measurements, with an ICC of 0.8365 and a 95% CI of 0.7512 to 0.8990, and for the Vi PLUS measurements, with an ICC of 0.9 and a 95% CI of 0.8515 to 0.9397. Conclusions: Renal stiffness and viscosity screening may become an efficacious, low-cost way to gather supplemental diagnostic data from patients with chronic kidney disease (CKD). The findings demonstrate that these non-invasive methods are highly feasible and not influenced by gender and that their values correlate with renal function and decrease with age progression. Nevertheless, more research is required to ascertain their place in clinical practice.

Ultrasonographic Assessment of Renal Length with Respect to Age and Sex: A Hospital Based Study

Introduction: Kidney is an important retroperitoneal organ with excretory and endocrine functions. The length of kidney is affected in variety of clinical disorders with age.&#x0D; Aims: The aim of the study was to determine the renal length with respect to individual’s sex and age.&#x0D; Methods: This study was conducted on 369 patients referred to department of Radiology for abdominal ultrasonographic examination where renal length was measured and recorded.&#x0D; Results: The mean right kidney length was found to be 9.3403 cm and the left mean kidney length was found to be 9.3490 cm. In comparison among male and female, males were found to have a greater mean kidney length. The maximum mean right kidney length was found in 50-59 years age groups while left kidney length was found maximum in 30-39 years age group.&#x0D; Conclusion: We performed ultrasonographic assessment of renal length with respect to age and sex in Nepalese population. We found that the kidney length of both left and right kidneys was related to age and sex.

Comparison Study between Fetal Kidney Length and Transcerebellar Diameter to Determine Gestational age in the Third Trimester

Introduction and Aim: An accurate determination of gestational age (GA) is crucial to the management of all pregnancies, particularly high-risk pregnancies. This study aimed to comparing between the accuracy of ultrasonographic fetal kidney length and Transcerebellar diameter in GA determination in third trimester.&#x0D; Patients and methods: The study was a cross sectional one, carried out at the department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt. The study had been performed between January 2021 and January 2022. All were submitted to a detailed history, routine antenatal investigations, general and obstetrical examination. Then, measurements of all fetal biometric parameters were recorded using a real- time, grayscale, 3.5–5.0 MHz curvilinear array transducer. Results were compared to the gestational age determined by last menstrual period.&#x0D; Results: The patient age ranged between 18 and 37 years, their weight ranged between 55 and 109 kg, while gravidity ranged between 1 and 5 and parity ranged between 0 and 4. The GA as determined by last menstrual period (LMP) was ranged between 28 and 40 weeks. The calculated GA by different measurements were also included and they were around the same measurements as determined by LMP. This was confirmed by the absent statistically significant difference between GA by LMP and any of calculated gestational age by any method. The mean fetal kidney length is more accurate in determination of gestational age than transcerebellar diameter (96.3% vs 89.8%) and both were significantly correlated with other calculated gestational ages.&#x0D; Conclusion: The length of the fetal kidney length proportionately correlated with fetal gestation age with powerful correlation coefficient. Fetal kidney length is found to be more accurate in GA determination than transcerebellar diameter (TCD).

Fetal kidney length as a useful adjunct parameter for determination of gestational age

Introduction: Accurate gestational age assessment is important in obstetric care ultrasonography. Fetal kidney length is one of the emerging parameter in estimation of fetal gestational age in 3rd trimester. Objectives: Is to the ascertain the precision of ultrasonographic fetal kidney length measurement as a reliable parameter for determination of gestational age in 3rd trimester. Materials and Methods: Cross-sectional observational study was conducted on 152 antenatal women in the 3rd trimester. Gestational age was estimated by early fetal ultrasound measure and last menstrual period. Results: Mean kidney length showed a Pearson’s correlation coefficient of 0.907 and a determination coefficient of 0.822 with GA. The test was significant at P &lt; 0.05. Conclusions: This study confirms that the fetal kidney length measurement for estimating the gestational age accurately in the 3rd trimester.

Determination of Gestational Age by Fetal Kidney Length Measurement After the 20th Week in Healthy Women With Uncomplicated Pregnancy in Tertiary Care Centre

Introduction: Various organs are measured to estimate the gestational age of fetus. Sonographically derived parameters used to date pregnancy include crown rump length, biparietal diameter, head circumference, femoral length and abdominal circumference. Fetal kidney length, transcerebellar diameter and placental thickness are emerging as new parameters and are claiming to be more accurate in certain situations. In Nepalese context fetal kidney length has not been studied yet so this study was done to fill this need. Methods: Obstetric sonography was performed in 108 pregnant women with uncomplicated pregnancy to evaluate the efficacy of FKL as a measure to calculate the predicted gestational age. Gestational age ranged from 20 weeks to term. Only patient with known LMP and previous history of normal menstrual cycle were included in the study. Results: The study showed mean fetal kidney length at 20 - 24, 25 - 29, 30 - 34 and 35 - 37 weeks gestation as 22.5 ± 0.5, 26.9 ± 0.7, 32.32 ± 0.7 and 36.3 ± 0.6 respectively. Overall in combined second and third trimester, fetal kidney length showed strong linear correlation with gestation age with highest significant Pearson correlation coefficient of 0.989 as compared to other parameters (BPD = 0.986, HC = 0.976, AC = 0.971, FL = 0.984). Conclusions: Fetal kidney showed strongest linear correlation with clinical gestational age and it also demonstrated positive correlation with biparietal diameter, head circumference, abdominal circumference and femur length. Therefore fetal kidney length can be used as a reliable parameter for determination of gestational age.

Accuracy of gestational age estimation using fetal kidney length in normal singleton pregnancies

Background A genuine appraise of gestational age (GA) plays a really vital part within the quality of care. Any wrong assessment can lead to perinatal morbidity and mortality from iatrogenic preterm or postnatal problems. Ultrasound estimation of fetal parameters is the premise for exact assurance of GA and detection of abnormalities of the fetal development. The choice of the foremost valuable single-biometric parameters depends on the timing and reason of the estimation and is influenced by different factors, especially in the second and third trimesters in which the evaluation of GA is accomplished by measuring the biparietal diameter, head circumference, abdominal circumference (AC), and femur length (FL). In the second half of pregnancy, the first trimester (CRL) is more dependable than those indices that become nonreliable as the pregnancy proceeds. Aim The aim was to evaluate the accuracy of fetal kidney length as a single indicator in estimation of GA. Patients and methods In total, 50 pregnant women with normal uncomplicated singleton pregnancy were subjected to complete history taking, general abdominal examination, and ultrasound measuring of PBD, AC, FL, right, and left kidney length. Results No noteworthy distinction was found between right and left renal lengths. The mean kidney length correlated well with the assigned GA. Fetal kidney length is considered a solid parameter, regardless of the fetal sex or kidney position. Conclusion Fetal kidney length can be utilized as an exact parameter for estimation of GA either exclusively or in combination with biparietal diameter, AC, and FL.

Determination of Gestational Age by Fetal Kidney Length Measurement after the 20th Week in Healthy Women with Uncomplicated Pregnancy in Tertiary Care Centre

Introduction: Various organs are measured to estimate the gestational age of fetus. Sonographically derived parameters used to date pregnancy include Crown rump length, Biparietal diameter, Head circumference, Femoral length and Abdominal circumference. Fetal kidney length, transcerebellar diameter and placental thickness are emerging as new parameters and are claiming to be more accurate in certain situations. In Nepalese context fetal kidney length has not been studied yet so this study was done to fill this need. Methodology: Obstetric sonography was performed in 108 pregnant women with uncomplicated pregnancy to evaluate the efficacy of FKL as a measure to calculate the predicted gestational age. Gestational age ranged from 20 weeks to term. Only patient with known LMP, previous history of normal menstrual cycle and without any exclusion criteria were included in the study. Results: The study showed mean fetal kidney length at 20-24, 25-29, 30- 34 and 35-37 weeks gestation as 22.5±0.5, 26.9±0.7, 32.32±0.7 and 36.3±0.6 respectively. Overall in combined second and third trimester , fetal kidney length showed strong linear correlation with gestation age with highest significant Pearson correlation coefficient of 0.989 as compared to other parameters (BPD=0.986, HC=0.976, AC=0.971, FL=0.984). Conclusion: Fetal kidney showed strongest linear correlation with clinical gestational age and it also demonstrated positive correlation with biparietal diameter, head circumference, abdominal circumference and femur length. Therefore fetal kidney length can be used as a reliable parameter for determination of gestational age.

ULTRASOUND MEASUREMENT OF FETAL KIDNEY LENGTH AS A PARAMETER FOR GESTATIONAL AGE DETERMINATION

Background: Accuracy in estimation of gestational age (GA) has become more demanding as technology used in ultrasonography has become more advanced. Patient’s expectations have also increased and they expect exact estimations to plan their pregnancies. Mean fetal kidney length (MFKL) alone or in combination with other biometric indices can be used for estimating GA more precisely. Objective: To measure the length of fetal kidney in normal singleton pregnancies in late second and early third trimesters, its correlation with GA derived from the first day of patient known last menstrual period (LMP) and comparison with GA derived from other conventional biometric methods. Patients and methods: This study was a prospective observational study, conducted at the department of Obstetrics & Gynecology, Obstetrics & Gynecology Hospital, Assiut, 500 pregnant females were enrolled in this study from March 2018 to March 2020. Those women underwent measurement of the right and left kidneys and mean was taken. Comparison between gestational ages was determined by LMP. In addition, mean fetal kidney length as well as between mean fetal kidneys length and other fetal biometric indices was done. Results: Baseline data of enrolled women (n= 500) mean age of those women was 26.31 ± 4.87 years. Median parity and abortion was 2 with range of both was between 0-6 and 0-8 times, respectively. Mean gestational age was 30.29 ± 3.34 weeks while mean body mass index was 19.84 ± 1.20 kg/m2. Average fetal kidney length was 29.88 ± 3.33 mm. Gestational ages based on different fetal biometric indices. Age by date had strong positive significant correlation with different fetal indices but the strongest correlation was observed with mean fetal kidney length (r= 0.96, P< 0.001). Correlation between gestational age by date and expected age by MFKL based on regression equation. That there was significant strong positive correlation between gestational age and expected age by MFKL (r= 0.97; P< 0.001). Conclusion: Mean fetal kidney length can be used as an accurate new parameter for estimation of gestational age in combination with BPD, HC, AC & FL especially in late second and early third trimester (beginning from 24th week – 34th week). Using regression equation: Gestational age by date (weeks) = 1.56+ 0.97 (MKL in mm).

Analysis of risk factors for progression of diabetic nephropathy in patients with type 2 diabetes

Introduction/Objective. The aim of the study was to examine the progression of diabetic nephropathy (DN) in a prospective three-year period as well as to establish the risk factors for DN progression. Methods. The study involved 45 patients with type 2 diabetes and DN (26 males, aged 18?62 years) followed up for three years. All the patients underwent physical examination and laboratory analysis at each visit. Laboratory analyses included complete blood count, serum glucose, urea, creatinine, protein, lipid concentration, glycosylated hemoglobin (HbA1c) and urine protein, albumin and creatinine concentration. Glomerular filtration rate (GFR) was calculated using Modification of Diet in Renal Disease formula. Kidney length and parenchymal thickness were measured by ultrasound. Results. Fasting serum glucose concentration (12.0 ? 2.79 vs. 9.50 ? 2.22, p &lt; 0.001) and HbA1c (7.99 ? 1.43 vs. 7.49 ? 1.29, p &lt; 0.031) were decreased over the three years. Albuminuria increased (43.75 ? 10.83 vs. 144.44 ? 52.70 mg/l, p &lt; 0.001) and GFR (63 vs. 58.3 ml/min/1.73 m2) decreased significantly during the study, but serum lipid concentration remained unchanged. Mean kidney length and parenchymal thickness decreased during the three years. Linear regression analysis found systolic blood pressure, fasting glycemia, HbA1c as positive and kidney length and parenchymal thickness as negative predictors of proteinuria increase, but proteinuria as negative and serum iron and albumin concentrations as positive predictors of annual change in GFR. Conclusion High blood pressure and high HbA1c are selected as significant risk factors for increasing proteinuria, which is a significant predictor of GFR decreasing in patients with DN.