Can measurement of the foetal renal parenchymal thickness with ultrasound be used as an indirect measure of nephron number?

Brennan, Sonja, Watson, David, Schneider, Michal, Rudd, Donna, and Kandasamy, Yogavijayan (2021) Can measurement of the foetal renal parenchymal thickness with ultrasound be used as an indirect measure of nephron number? Journal of Developmental Origins of Health and Disease. (In Press)

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Abstract

Chronic kidney disease continues to be under recognised and is associated with a significant global health burden and costs. An adverse intrauterine environment may result in a depleted nephron number and an increased risk of chronic kidney disease. Antenatal ultrasound was used to measure the foetal renal parenchymal thickness (RPT), as a novel method to estimate nephron number. Foetal renal artery blood flow was also assessed. This prospective, longitudinal study evaluated the foetal kidneys of 102 appropriately grown and 30 foetal growth-restricted foetuses between 20 and 37 weeks gestational age (GA) to provide vital knowledge on the influences foetal growth restriction has on the developing kidneys. The foetal RPT and renal artery blood flow were measured at least every 4 weeks using ultrasound. The RPT was found to be significantly thinner in growth-restricted foetuses compared to appropriately grown foetuses [likelihood ratio (LR) = 21.06, P ≤ 0.0001] and the difference increases with GA. In foetuses with the same head circumference, a growth-restricted foetus was more likely to have a thinner parenchyma than an appropriately grown foetus (LR = 8.9, P = 0.0028), supporting the principle that growth-restricted foetuses preferentially shunt blood towards the brain. No significant difference was seen in the renal arteries between appropriately grown and growth-restricted foetuses. Measurement of the RPT appears to be a more sensitive measure than current methods. It has the potential to identify infants with a possible reduced nephron endowment allowing for monitoring and interventions to be focused on individuals at a higher risk of developing future hypertension and chronic kidney disease.

Item ID: 66271
Item Type: Article (Research - C1)
ISSN: 2040-1752
Keywords: Renal parenchyma; foetal renal artery; foetal growth restriction; nephron number; ultrasound
Copyright Information: © Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2020.
Funders: Australasian Society for Ultrasound in Medicine (ASUM), Townsville Hospital Study, Education and Research Trust Award (SERTA)
Projects and Grants: ASUM research grant 2018, SERTA grant 27_2016
Date Deposited: 02 Mar 2021 02:24
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3215 Reproductive medicine > 321501 Foetal development and medicine @ 50%
32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320222 Radiology and organ imaging @ 25%
32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320214 Nephrology and urology @ 25%
SEO Codes: 20 HEALTH > 2002 Evaluation of health and support services > 200201 Determinants of health @ 100%
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