Daniel AR et al. – This study investigated the clinical association of total kidney volume (TKV), renal function and cardiovascular disease (CVD). The authors concluded that low TKV is associated with kidney damage, including albuminuria and estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, and high TKV with diabetes and decreased odds of eGFR <60 mL/min/1.73 m2. However, prospective studies are required to characterize the natural progression and clinical consequences of TKV.

Methods

• Magnetic resonance imaging was used to measure TKV in 1852 Framingham Heart Study participants (mean age 64.1 ± 9.2 years, 53% women).
• Reference values were defined using a healthy sample, and multivariable logistic regression analysis was used for determining the associations between TKV, renal function, and CVD risk factors.

Results

• Mean TKV of men and women was 278 ± 54 cm3 and 365 ± 66 cm3, respectively.
• The major risk factors for high TKV (>90% healthy referent size) were body surface area (BSA), diabetes, smoking, and albuminuria, while the protective factors included age, female gender, and eGFR <60 mL/min/1.73 m2.
• Individuals with high TKV had higher odds of diabetes (odds ratio [OR] 2.15, P<.001) and lower odds of eGFR <60 mL/min/1.73 m2 (OR 0.32, P = .007).
• Age, female gender, and eGFR <60 mL/min/1.73 m2 were the risk factors for low TKV (<10% healthy referent size), while protective factors included BSA and diabetes.
• Individuals with low TKV had higher odds of eGFR <60 mL/min/1.73 m2 (OR 6.12, P<.001) and albuminuria (OR 1.56, P = .03).