Age dependency of the renal resistive index in healthy children

It has recently been suggested that the resistive index (RI) in native kidneys of healthy children is age dependent; however, this relationship has not been completely defined or explained. In 110 kidneys in 71 healthy children aged newborn to 11 years, RIs were determined from peripheral sites (presumed to be arcuate, cortical, or distal interlobar arteries). The authors found the normal renal RI (the mean RI in each kidney) to be age dependent. The renal RI in children is commonly elevated above the upper normal limit in adults (0.70) in the 1st year of life, and the overall trend shows a decrease with age. From 4 years on, the likelihood is low (2% probability) that the RI is above 0.70. Variability of the renal RI from individual to individual was most marked in the first 6 months of life, with 51% (19 of 37) of these kidneys having an RI that would be considered abnormal by adult standards. It is concluded that the normal renal RI is age dependent, with an overall decreasing trend with increasing age. This age dependency of the renal RI and, hence, of the renal vascular resistance might be dependent on levels of active renin, as the maturational profile of the renal RI more closely parallels that of active renin than those of other renal functional parameters.