Doloretta Piras1, Marco Masala2, Alessandro Delitala3, Silvana A M Urru4, Nicolò Curreli3, Lenuta Balaci3, Liana P Ferreli3, Francesco Loi3, Alice Atzeni1, Gianfranca Cabiddu1, Walter Racugno5, Laura Ventura6, Magdalena Zoledziewska2, Maristella Steri2, Edoardo Fiorillo3, Maria G Pilia3, David Schlessinger7, Francesco Cucca2,8, Andrew D Rule9,10, Antonello Pani1,2. 1. Struttura complessa di Nefrologia e Dialisi, Azienda Ospedaliera G. Brotzu, Cagliari, Italy. 2. Istituto di Ricerca Biomedica e Genetica, Consiglio Nazionale delle Ricerche, Monserrato (Cagliari), Italy. 3. Center ProgeNIA, Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle Ricerche, Lanusei, Italy. 4. Biomedicine Sector, Center for Advanced Studies Research and Development in Sardinia (CRS4), Technology Park Polaris, Cagliari, Italy. 5. Dipartimento di Statistica, Università degli Studi di Cagliari, Cagliari, Italy. 6. Dipartimento di Statistica, Università di Padova, Padua, Italy. 7. Laboratory of Genetics, National Institute on Aging, Baltimore, MD, USA. 8. Dipartimento di Scienze Biomediche, Università degli Studi di Sassari, Sassari, Italy. 9. Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA. 10. Division of Epidemiology, Mayo Clinic, Rochester, MN, USA.
Abstract
BACKGROUND: The relationship of kidney size to ageing, kidney function and kidney disease risk factors is not fully understood. METHODS: Ultrasound length and parenchymal kidney volume were determined from a population-based sample of 3972 Sardinians (age range 18-100 years). We then identified the subset of 2256 'healthy' subjects to define age- and sex-specific reference ranges (2.5-97.5 percentile) of kidney volume. Logistic regression (accounting for family clustering) was used to identify the clinical characteristics associated with abnormally large kidneys or abnormally small kidneys. RESULTS: In the healthy subset, kidney volume and length increased up to the fourth to fifth decade of life followed by a progressive decrease in men, whereas there was a gradual kidney volume decrease throughout the lifespan of women. In the whole sample, independent predictors of lower kidney volume (<2.5 percentile for age and sex) were male sex, low body mass index, short height, low waist:hip ratio and high serum creatinine (SCr); the independent predictors of larger kidney volume (>97.5 percentile for age and sex) were younger age, female sex, diabetes, obesity, high height, high waist:hip ratio and lower SCr. Estimated heritability for kidney volume was 15%, and for length 27%; kidney volume correlated strongly with birthweight. CONCLUSIONS: Overall, in a general healthy population, kidney measures declined with age differently in men and women. The determinants of kidney parenchymal volume include genetic factors and modifiable clinical factors. Published by Oxford University Press on behalf of ERA-EDTA 2018. This work is written by US Government employees and is in the public domain in the US.
BACKGROUND: The relationship of kidney size to ageing, kidney function and kidney disease risk factors is not fully understood. METHODS: Ultrasound length and parenchymal kidney volume were determined from a population-based sample of 3972 Sardinians (age range 18-100 years). We then identified the subset of 2256 'healthy' subjects to define age- and sex-specific reference ranges (2.5-97.5 percentile) of kidney volume. Logistic regression (accounting for family clustering) was used to identify the clinical characteristics associated with abnormally large kidneys or abnormally small kidneys. RESULTS: In the healthy subset, kidney volume and length increased up to the fourth to fifth decade of life followed by a progressive decrease in men, whereas there was a gradual kidney volume decrease throughout the lifespan of women. In the whole sample, independent predictors of lower kidney volume (<2.5 percentile for age and sex) were male sex, low body mass index, short height, low waist:hip ratio and high serum creatinine (SCr); the independent predictors of larger kidney volume (>97.5 percentile for age and sex) were younger age, female sex, diabetes, obesity, high height, high waist:hip ratio and lower SCr. Estimated heritability for kidney volume was 15%, and for length 27%; kidney volume correlated strongly with birthweight. CONCLUSIONS: Overall, in a general healthy population, kidney measures declined with age differently in men and women. The determinants of kidney parenchymal volume include genetic factors and modifiable clinical factors. Published by Oxford University Press on behalf of ERA-EDTA 2018. This work is written by US Government employees and is in the public domain in the US.
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