Genetic and environmental variance of renal parenchymal thickness: a twin study

Tárnoki, Dávid László; Tárnoki, Ádám Domonkos; Littvay, Levente; Bata, Pal; Bérczi, Viktor; Garami, Zsolt; Karlinger, Kinga

doi:10.3325/cmj.2013.54.550

Cited by 7 publications

(6 citation statements)

References 21 publications

(18 reference statements)

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“…An age-related decline in renal function in elderly patients, considered normal by DOQI guidelines [ 26 ], did not have a significant impact on renal cortical thickness in our study [ 27 ]. Cortical thickness in a recent study of monozygotic and dizygotic adult twins showed the negligible role of heritability and the important role of environment on renal parenchymal thickness [ 28 ]. The generation of reference graphs for normal renal length and cortical thickness in our Kuwaiti population could offer a comparison for future studies evaluating patients with renal abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Sonographic Assessment of Renal Size in Healthy Adults

El-Reshaid

Abdul-Fattah

2014

Med Princ Pract

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Objective: To assess the normal sonographic values of renal length and cortical thickness in healthy adults and establish reference ranges in our population for comparison when examining renal disease. Subjects and Methods: Sonographic assessment of renal length and cortical thickness were performed from January 2006 to December 2011 in 252 healthy individuals who were self-referred to the El-Reshaid Renal Clinic in Kuwait. They were screened for the absence of renal abnormalities. Weight and height were measured, and body mass index (BMI) and body surface area calculated. Patients were divided into 5 age groups: 18-30, 31-40, 41-50, 51-60 and 61 -80 years, in order to generate reference graphs for renal length and cortical thickness. Results: The mean renal lengths for the right and left kidney were 10.68 ± 1.4 and 10.71 ± 1.0 cm, respectively (p = 0.56) without a significant change with age. The minimum cortical thickness was 0.6 cm. The renal length correlated with the weight of the patients (p < 0.01) and their BMI (p < 0.01) but not with their height. There was no difference in renal size or cortical thickness in patients older than 60 years despite an age-related decline in the glomerular filtration rate (p < 0.001). Conclusions: Renal length and cortical thickness did not vary significantly with age. Renal length correlated well with weight and BMI but not with height. Hence, establishing normal ranges of renal parameters is essential for comparison in situations where possible renal disease is being investigated.

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Section: Discussionmentioning

confidence: 99%

Sonographic Assessment of Renal Size in Healthy Adults

El-Reshaid

Abdul-Fattah

2014

Med Princ Pract

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“…On the other hand, we ignored the influence of hypertension, since hypertension was reported to have no effect on renal ADC value, even though it causes end-organ damage (20). Additionally, there may be some other factors, such as age or environmental effects, which may be associated with alterations in renal morphology or function (21,22). Although the proportion of our geriatric patients was very small, renal aging may potentially influence our outcomes.…”

Section: Discussionmentioning

confidence: 99%

Renal diffusion-weighted imaging in diabetic nephropathy: correlation with clinical stages of disease

Çakmak¹,

Yağcı²,

Dursun³

et al. 2014

Diagn Interv Radiol

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Original Article PURPOSE We aimed to assess the correlation between renal apparent diffusion coefficient (ADC) values measured by diffusion-weighted imaging (DWI) and the clinical stages of diabetic nephropathy. MATERIALS AND METHODS DWI (b value, 0 and 600 s/mm2 ) was performed in 78 patients with clinically confirmed diabetic nephropathy (study group) and 22 volunteers without diabetes mellitus or any renal disease (control group). The mean ADCs were calculated from multiple region-of-interest circles positioned in the renal cortex. Diabetic nephropathy was clinically categorized into five stages based on the values of urinary albumin excretion and glomerular filtration rate (GFR). RESULTSMean renal ADC values of patients with stage 3 or 4 disease were significantly lower than those in patients with stage 1 or 2 disease and the control group (P < 0.001). ADC values of patients with stage 5 disease were significantly lower than those in patients with stage 4 (P = 0.003), stage 3 (P = 0.020), stages 2 and 1, and the control group (P < 0.001). Significant correlations were found between mean renal ADC values and clinical stages of diabetic nephropathy (r=−0.751, P < 0.001), between mean renal ADC values and estimated GFR values (r=0.642, P < 0.001), and between mean renal ADC values and urinary albumin excretion (r=−0.419, P < 0.001). CONCLUSIONRenal ADC values show a significant correlation with clinical stages of diabetic nephropathy. As a relatively simple and noninvasive tool without contrast media administration, renal quantitative DWI may potentially play a role in making clinical decisions in the follow-up of diabetic patients. Diabetic nephropathy is classically defined as a clinical syndrome characterized by persistent albuminuria, a relentless decline in glomerular filtration rate (GFR) progressing to end-stage renal disease, raised arterial blood pressure, and enhanced cardiovascular morbidity and mortality (1). In diabetic patients, renal functional deterioration is the result of heterogeneous renal structural changes, including glomerular basal membrane thickening and mesangial expansion, extracellular matrix accumulation, mesangiolysis, reduced podocyte number, microaneurysm formation, arteriolar hyalinosis which ultimately leads to glomerulosclerosis, tubular atrophy, interstitial expansion, and fibrosis (2). Renal damage occurs in multiple stages. Throughout its early stages, diabetic nephropathy has no symptoms. Persistent microalbuminuria is a predictor of the development of clinical nephropathy. Microalbuminuria has been proposed as a marker of widespread endothelial dysfunction and indicates microvascular damage (3). Better understanding of the mechanisms that lead to structural and functional changes in the diabetic kidney may facilitate the development of more effective follow-up and treatment modalities. Diagnostic tests that help identify early microvascular damage at an early stage will provide significant benefits to get the disease under control. Quantitative diffusion-weighted magnetic...

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“…[9][10][11][12][13][14][15][16][17] Several explanations for these discrepancies have been offered, including selection bias, insufficient control of confounders, or problems with normalization of body surface area in estimated glomerular filtration rate equations. 9,15,18,19 Because both BMI 20 and CKD [21][22][23] are partly inherited, genetic factors shared by obesity and CKD may also account for the association and thus genetic confounding is possibly another important source of bias. Although multiple metabolic factors have been proposed to contribute to obesity-induced CKD, the underlying signaling mechanisms are not completely understood.…”

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confidence: 99%