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On Sep 2018




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Prof. Somashekhar Nimbalkar
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Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
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Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
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Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
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Professor and Head
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Saraswati Dental College
Lucknow
On Sep 2018




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Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




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Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2023 | Month : June | Volume : 17 | Issue : 6 | Page : PC18 - PC22 Full Version

Determination of Renal Volume using Ultrasonography and its Correlation with Renal Function: A Cross-sectional Study


Published: June 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/59775.18126
Ankit Sandhu, Sandeep Gupta, Dilip Kumar Pal

1. Photodynamic Therapist (PDT), Department of Urology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India. 2. Associate Professor, Department of Urology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India. 3. Professor and Head, Department of Urology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India.

Correspondence Address :
Dilip Kumar Pal,
244, AJC Bose Road, Kolkata, West Bengal, India.
E-mail: urologyipgmer@gmail.com

Abstract

Introduction: Renal length and volume are important indicators for the presence or progression of disease in urology and nephrology. Estimation of renal volume by Ultrasonography (USG) has clinical utility for the physician, nephrologist, and urologist.

Aim: To measure individual renal volume by ultrasonography and determine its relationship with renal function as measured by the Diethylene Triamine Penta-acetic Acid (DTPA) in normal adults.

Materials and Methods: It was a cross-sectional study conducted on 50 patients who underwent DTPA scans both in Outpatient (OPD) and In-Patient Department (IPD) in the Department of Urology, Institute of Postgraduate Medical Education and Research and SSKM Hospital, Kolkata, West Bengal, India, from January 2020 to December 2020. All the transplant donors who underwent donor nephrectomy were included in the study. A sonographic assessment was done and the Glomerular Filtration Rate (GFR) was calculated by Technetium (Tc)-154 DTPA. The primary outcome was to determine the relationship between renal volume with renal function in normal adults. The secondary outcome was to measure individual renal parameters sonographically. They were assessed for correlation between renal parameters (mainly renal volume) and DTPA using Pearson’s coefficient.

Results: The age range of the subjects was 18-70 years. GFR calculated by DTPA for the right kidney had a better correlation with renal volume (r=0.241) on the right and 0.162 on the left, both with a p-value of 0.001. GFR of the left kidney had a better correlation with left kidney volume (r=0.184) than right kidney volume (r=0.130). No correlation was found between GFR with renal Anteroposterior (AP) dimension, renal width, and renal length. The kidney volume was more significant on the left-side (r=0.351) than on the right kidney (r=0.263).

Conclusion: Renal volume correlated well with renal function. Sonographic assessment of renal volume rather than renal length would serve as a tool to evaluate renal status for evaluation and follow-up.

Keywords

Diethylene triaminepentaacetic acid, Glomerular filtration rate, Pearson coefficient, Renal length

Renal length and volume are important indicators for the presence or progression of disease in urology and nephrology practice (1). The assessment of renal disease using biochemical assay is often carried out by the estimation of serum electrolyte, urea, and creatinine in blood and also through the determination of the amount of endogenous or exogenous substances present in urine (urinalysis, 24 hours creatinine or iohexol clearance) (2),(3),(4). Renal function can be determined from the GFR by estimating endogenous creatinine clearance using the Cockcroft-Gault equation (5),(6),(7). GFR can also be calculated by recording the clearance of exogenous substances that are eliminated by filtration only and neither secreted nor reabsorbed in the kidney. It includes renal marker and plasma marker clearance of chromium 512 labelled Ethylenediaminetetraacetic Acid (51Cr-EDTA), DTPA, iohexol, and iothalamate (8).

Estimation of renal volume by ultrasonography reflects renal mass or the number of surviving nephrons. Renal volume tells about the functional capacity of the kidneys (1). Alteration in kidney volume can be associated with different renal diseases. Renal volume, rather than length, has been proposed as a true predictor of kidney size in states of good health and disease (2),(3),(4).

According to Emamian SA et al., the renal volume gives the most exact measurement of renal mass and better correlates with body surface area. Renal length on the other hand correlates with body height (4). More so, renal volume is said to be stable with minimal change as one ages (3). Widjaja E et al., (study done in UK) stated that renal volume is a more sensitive measure of detecting renal abnormality than any single linear measurement and better correlates with renal mass and estimated Glomerular Filtration Rate (eGFR), respectively (9). To our knowledge, such a study correlating renal volume with DTPA has not been done in India.

The aim of the study was to provide a range of values of renal volume in the normal adult population and to determine the relationship between renal volume and anthropometric parameters such as age, weight, height, Body Mass Index (BMI), and gender.

Material and Methods

It was a cross-sectional study conducted on the patients who underwent DTPA scans both in OPD and IPD in the Department of Urology, Institute of Postgraduate Medical Education and Research and SSKM Hospital, Kolkata, West Bengal, India, from January 2020 to December 2020. The study was approved by the Institutional Ethical Committee (Memo no. IPGME&R/IEC/2020/178, dated 18.02.2020). As the average number of live transplant patients per year was forty, so a total number of patients included was fifty transplant donors that underwent transplant during the course of the study.

Inclusion criteria: All the transplant donors who underwent donor nephrectomy were included in the study. Those adults aged 18-60 years who gave consent for the procedure with the absence of any history of renal disease, a malignant or systemic illness that may modify renal dimensions like diabetes mellitus, renal artery stenosis, renal cancer, etc., with an arterial normotensive blood pressure of <140/90 mmHg, normal renal function (confirmed by normal serum creatinine <1.5 mg/dL and normal eGFR), with BMI <30 kg/m2 and patients who underwent DTPA scan for urological indications like renal transplant donor, unilateral ureteric obstruction (like Pelvi-ureteric Junction Obstruction (PUJO), Extrinsic compression) were included in the study.

Exclusion criteria: Pregnant women or postpartum women (within the last 3 months), participants in whom the entire renal outline was not properly visible in a prone position during USG (despite deep breathing exercises), and patients with a history of prior surgery like atrophic nephrolithotomy, partial nephrectomy, Percutaneous Nephrolithotomy (PCNL), Extracorporeal Shock Wave Lithotripsy (ESWL) as these procedures cause nephron loss and hence affect renal function. Obese subjects were excluded from this study.

Study Procedure

The procedure was explained to all the subjects, and informed consent was obtained. History was taken for each adult, including age, gender, and the presence of any illness (acute/chronic) excluded. Healthy kidney of the patients was taken up for the measurement of renal volume for correlation with DTPA.

Systolic as well as diastolic blood pressure (with the help of mercury column sphygmomanometer), standing height (by stadiometer), weight (by weighing machine), and BMI were calculated. Using this, the patients were categorised as underweight (<18.5 kg/m2), normal or lean BMI (18.5-22.9 kg/m2), overweight (23.0-24.9 kg/m2) and obese (≥25 kg/m2). Subjects underwent (99 m) Tc-DTPA scan. On ultrasonography, the superior and inferior poles were identified and marked on the longitudinal scan of the kidney. The longest distance between the poles using an electronic calliper was taken as renal length. Similarly, on the longitudinal scan, the maximum distance between the anterior and posterior walls at the mid-third of the kidney was taken as Antero-posterior (AP) diameter (thickness). The renal width (W) was measured from the maximum transverse diameter at the hilum on the transverse scan (Table/Fig 1). In view to minimise intraobserver error, the mean of two readings were taken. The unit of measurement was a centimetre (cm). Renal volume was calculated using the formula: L×W×AP×0.523 (2),(10).

Statistical Analysis

Data were recorded in the participant’s ultrasound data sheet and transferred into Microsoft excel (Microsoft Corporation, USA) and Statistical Package for Social Science for windows (SSPS Inc. Chicago IL, USA) version 25.0. The correlation between parameters was derived using Pearson coefficient correlation.

Results

A total of 50 subjects were systematically selected for the study out of which 19 (38%) were females and 31 (62%) were males. The age range of the subjects was 18-70 years with a mean age 47.95 (±11.54) years and 43.74 (±10.437) years for males and females, respectively (Table/Fig 2). Serum creatinine values of male (0.94±0.14 mg/dL) were significantly higher than females (0.84±0.11 mg/dL) with p-value of 0.008. On both sides, GFR (derived from DTPA) in males had a higher value than in females as shown in (Table/Fig 3).

The mean renal length for the total population was greater on the left than the right. The difference in right kidney and left kidney with respect to total population was found to be significant with p-value of 0.004 and p-value of 0.008, respectively as shown in (Table/Fig 4). There was a marked correlation between the subjects age and renal length on both the right kidney (r=-0.357) and left kidney (r=-0.390). The strongest correlation was observed between the subject’s BMI and left kidney AP dimension (r=0.310) as shown in (Table/Fig 5).

There was no significant difference in GFR value calculated by DTPA on either side in normal, underweight and overweight individuals as shown in (Table/Fig 6). GFR calculated by DTPA for the right kidney was seen to have a better correlation with renal volume (r=0.241 on the right and 0.162 on the left, both with p-value of 0.001). GFR of the left kidney had a better correlation with left kidney volume (r=0.184) than right kidney volume (r=0.130). No correlation was found about GFR with renal AP dimension, renal width and renal length with p-value >0.05 as shown in serum creatinine (mg/dL) was seen to have the better correlation with renal width on the left-side (r=0.319) than on the right-side (r=0.220) (Table/Fig 7).

On plotting correlation of renal volume with GFR on a scatter diagram, most points were seen to cluster around the line of best fit and trend line showing increasing trend, showing a higher positive correlation with GFR (Table/Fig 8),(Table/Fig 9). Linear regression equations from independent variables (age, height and weight) for both females and males, respectively are shown in (Table/Fig 10),(Table/Fig 11). GFR can be calculated using the prediction equation from the renal volume as seen in both females and males respectively as well as for total subjects (Table/Fig 12),(Table/Fig 13),(Table/Fig 14).

Discussion

The sonographic assessment of renal dimensions is an integral tool for the evaluation and serial follow-up of suspected renal disease in adults, especially in urological and nephrological settings. Sonographic renal size assessment remains the most reproducible, real-time, tridimensional, non invasive, non ionising, easy, quick, affordable, and accessible modality for evaluating renal dimensions (10).

A number of reports have described ultrasonographic measurements of renal length and volume in the healthy Western population and African population but there are scant data regarding the same in Asian countries. The overall length of right kidney was found to be 9.48±0.35 cm and left kidney to be 9.52±0.39 cm. The overall mean renal length (right 10.4 cm and left 10.6 cm) in the study done by Okoye I et al., in South eastern Nigeria was found to be higher (11).

Similar results were found in the present study when compared with Eastern India study population results. This similarity could probably be due to similar body habitus and type of diet of this part of the country (13). Moreover, the values of the present study were similar to the North western Indian and Pakistan findings by Shani D et al., and Raza M et al., respectively [14,15]. Mean renal width and (AP) depth obtained in this study were slightly higher than those in the Pakistani population (Table/Fig 15) (4),(12),(13),(14),(15).

It is shown that the left kidney is somewhat larger than the right kidney. It is thought that the left renal artery is shorter in length, which increases blood flow to the left kidney, leading to the increase in the size of the kidney (16). Another reason could be due to the fact that the liver is bigger than the spleen, giving the right kidney less space to grow. Physiologically, renal length is shown to decrease by 0.5 cm per decade after middle age (4). Studies have also tried to establish a correlation between renal size and age (17). The length and renal volume in subjects aged between 30-50 years showed slight differences and a clear decrease in both parameters (4).

There was no correlation between renal length and height in this study (r=0.120, 0.137 for the left and right-side, respectively), whereas studies done by Adebayo SB et al., Gavela T et al., and Fernandes MM et al., showed strong correlation (18),(19),(20). This finding was at variance to studies done by Okoye I et al., Maaji SM et al., who reported that renal length correlated best with body weight (11),(13). Renal volume in this study showed no significant correlation with body weight on both sides with an r value of 0.028 and 0.096 on the right and left-side; this was in contrast with studies done in South Western Nigeria and in the Turkish Population which showed significant correlation between renal volume and body weight (21),(22).

In the present study, BMI showed a good correlation with AP dimension of left kidney (r=0.310). In a study by Cheong B et al., rather showed that the renal length correlated better with BMI than renal volume (23).

The correlation between renal volume and function is important. Okur A et al., and Cheong B et al., have shown that renal volume strongly correlates with eGFR, and implied that since renal volume varies with metabolic demand, it is therefore closely linked to renal function [22,23]. The present study also showed that renal volume correlated better with GFR, hence, a better index of measurement of renal function than renal length which is the same as proposed Moorthy HK and Venugopal P; and Cheong B et al., (2),(23). Gong IH et al., observed that renal volume best correlated with eGFR than with body height and weight with correlation coefficients of 0.615, 0.344 and 0.343 respectively, each with significant p-value of <0.0140 (24).

The established equations can be used to predict renal length and volume in males and females, provided the subject’s age, height and weight is known, especially in remote settings where access to sonography may be unavailable due to poor access roads or absence of an ultrasound machine/qualified radiologist/sonologist. However, when the subject’s height and weight is not known but renal sonography has been done, in such cases GFR can be calculated from the sonographically determined renal dimensions (especially renal volume).

Limitation(s)

The sample size was restricted to renal transplant donors as they reflected the normal adult population. Similar studies should be conducted in infants and children, using Computerised tomography and Magnetic resonance imaging. A multicentre study to draw a normogram for the whole country is encouraged.

Conclusion

Renal volume had best correlated with renal function. Sonographic assessment of renal volume rather than renal length is therefore clinically relevant and would serve as a tool to evaluate renal status for evaluation and follow-up. It should be integrated into our daily routine as this would inform the clinicians on the functional reserve of the renal status of the individual and not just the renal length and AP dimensions as is common practice. The prediction equations could also serve as an alternative measure for the assessment of renal dimensions and GFR in remote settings where DTPA facilities are not available or in a busy practice where urgent renal status evaluation is required in the studied population.

References

1.
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DOI and Others

DOI: 10.7860/JCDR/2023/59775.18126

Date of Submission: Aug 23, 2022
Date of Peer Review: Sep 22, 2022
Date of Acceptance: Jan 05, 2023
Date of Publishing: Jun 01, 2023

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Sep 02, 2022
• Manual Googling: Dec 28, 2022
• iThenticate Software: Jan 03, 2023 (11%)

ETYMOLOGY: Author Origin

EMENDATIONS: 7

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