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Updated: Apr 27, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Decrease rate of the renal diameter in chronic hemodialysis patients
Teiichiro Aoyagi1, Masaaki Tachibana2, Shinji Naganuma3
1Department of Urology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo Ami, Ibaraki, Inashiki 300-0395, Japan.
Insights
Chronic hemodialysis (HD) patients experienced an average annual decrease of 4.3 mm in renal diameter. This shrinkage rate slowed significantly with longer durations of HD treatment.
Area of Science:
- Nephrology
- Radiology
- Urology
Background:
- Chronic hemodialysis (HD) is a life-sustaining treatment for end-stage renal disease.
- Understanding kidney size changes in HD patients is crucial for monitoring disease progression and treatment effects.
- Previous studies have not extensively detailed renal diameter alterations over time in HD populations without specific kidney diseases.
Purpose of the Study:
- To evaluate the longitudinal changes in renal diameter among chronic hemodialysis patients.
- To determine the rate of renal diameter alteration and identify factors influencing it.
- To investigate the relationship between hemodialysis vintage and the rate of renal size decrease.
Main Methods:
- Ultrasonography (US) was used to measure the maximum renal diameter in 109 chronic HD outpatients.
- Patients without severe acquired cystic kidney disease or hereditary polycystic kidney disease were included.
- Renal diameter measurements were taken 2-3 times, with an average interval of 35.9 months, to calculate the yearly alteration rate.
Main Results:
- The average decrease rate of renal diameter was 4.34 ± 0.4 mm/year.
- No significant differences in the decrease rate were observed based on gender, age, or the underlying cause of kidney disease.
- A higher decrease rate was noted when measurements were taken closer to the initiation of HD, indicating a slowing trend with increased hemodialysis vintage.
Conclusions:
- Renal diameter progressively decreases in chronic HD patients, averaging approximately 4.3 mm annually.
- The rate of renal diameter reduction is inversely related to the duration of hemodialysis treatment.
- These findings highlight the impact of long-term hemodialysis on kidney morphology and suggest that renal size stabilization may occur with prolonged treatment duration.
Abstract:
We here present the results of ultrasonographic (US) evaluations on the alteration of renal diameter of chronic HD patients. Of 109 outpatient HD patients who had neither severe acquired cystic disease of the kidney nor hereditary polycystic kidney disease, we performed US two or three times to measure their maximum renal diameter (mean of both kidneys), and the yearly alteration rate was calculated. The average interval of the two measurements was 35.9 months, and the average HD duration from the HD induction to the first measurement was 29.5 months. The average decrease rate of renal diameter was 4.34 ± 0.4 (SE) mm/year. No statistical difference was seen on the decrease rate in relation to gender, age and original disease (among three groups, glomerulonephritis and IgA nephropathy, diabetes, and others including hypertension). However, the decrease rate was large when the first measurement was close to the induction of hemodialysis, suggesting that the alteration rate reduced according to the hemodialysis vintage (5.3 ± 0.8 mm/year, first measurement not more than 10 months after induction of HD and 1.5 ± 1.6 mm/year, first measurement more than 80 months after induction of HD). Renal diameter decreased approximately 4.3 mm each year, and the decrease rate slowed as the length of time on dialysis increased.
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