Pediatr Nephrol. 2007;22:857-863


Malnourished children have smaller kidneys, and body height is the main determinant of their kidney length and volume, Turkish investigators conclude.

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A team led by Aydin Ece, MD, of DicleUniversity in Diyarbakir, compared 74 children with energy malnutrition (marasmus) and a group of 47 healthy children. Kidney size was measured by the same radiologist using ultrasonography. The mean age of the subjects was 29.6 months in the malnourished group and 27.6 months in the control arm.


Compared with controls, the malnourished children had lower weight (6.0 vs. 12.9 kg), height (67.5 vs. 85.9 cm), BMI (12.9 vs. 17.8 kg/m2), and body surface area (0.32 vs. 0.51 m2). Malnourished children had significantly lower combined renal volume compared with controls (46.8 vs. 55.9 cm3), but they had significantly higher mean relative combined kidney volume (8.14 vs. 4.91 cm3/kg).


The mean length of the right and left kidney was 56.6 and 59.1 mm in the malnourished group, respectively, compared with 64.4 and 68.1 mm in the controls. The mean depth of the right and left kidney was 24.9 and 27.0 mm in the malnourished children and 26.3 and 29.5 mm in the control. The parenchymal width in the right and left kidney was 6.8 and 7.3 mm in the malnourished group and 9.5 and 10.5 mm in the controls.


The strongest positive correlations were between subjects’ height and kidney size in malnourished children.


“Kidney size differences of marasmic children should be kept in mind while assessing their renal ultrasound imaging,” the authors noted. “The potential long-term consequences of poor renal growth, such as increased risk of hypertension or tendency to development of chronic renal insufficiency, need to be investigated in malnourished children by further longitudinal studies.”