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Clinical associations of total kidney volume: the Framingham Heart Study
Daniel A Roseman1, Shih-Jen Hwang1,2, Noriko Oyama-Manabe3
1National Heart, Lung and Blood Institute, Framingham Heart Study, Framingham, MA, USA.
Insights
Total kidney volume (TKV) is linked to kidney damage and diabetes. Low TKV indicates kidney damage, while high TKV is associated with diabetes and lower odds of severe kidney dysfunction.
Area of Science:
- Nephrology
- Radiology
- Cardiovascular Medicine
Background:
- Total kidney volume (TKV) is an imaging biomarker with potential diagnostic and prognostic utility.
- Relationships between kidney volume, renal function, and cardiovascular disease (CVD) are not well-characterized in large community populations.
- Understanding these relationships is crucial for advancing the clinical application of TKV.
Purpose of the Study:
- To characterize the associations between total kidney volume (TKV), renal function, and cardiovascular disease (CVD) risk factors in a large community-dwelling population.
- To establish reference values for TKV in a healthy sample.
- To identify risk factors associated with high and low TKV.
Main Methods:
- Magnetic resonance imaging (MRI) was used to measure TKV in 1852 participants from the Framingham Heart Study.
- A healthy subset was used to define reference TKV values.
- Multivariable logistic regression analysis assessed associations between TKV, renal function (eGFR, albuminuria), and CVD risk factors (diabetes, BSA, smoking).
Main Results:
- High TKV was associated with increased odds of diabetes (OR 2.15) and decreased odds of eGFR <60 mL/min/1.73 m2 (OR 0.32).
- Risk factors for high TKV included body surface area (BSA), diabetes, and smoking; age, female sex, and eGFR <60 mL/min/1.73 m2 were protective.
- Low TKV was associated with increased odds of eGFR <60 mL/min/1.73 m2 (OR 6.12) and albuminuria (OR 1.56).
Conclusions:
- Low TKV is linked to markers of kidney damage, such as albuminuria and reduced eGFR.
- High TKV is associated with diabetes and paradoxically lower odds of severely reduced eGFR.
- Further prospective studies are needed to understand the progression and clinical impact of TKV variations.
Background:
Total kidney volume (TKV) is an imaging biomarker that may have diagnostic and prognostic utility. The relationships between kidney volume, renal function and cardiovascular disease (CVD) have not been characterized in a large community-dwelling population. This information is needed to advance the clinical application of TKV.
Methods:
We measured TKV in 1852 Framingham Heart Study participants (mean age 64.1 ± 9.2 years, 53% women) using magnetic resonance imaging. A healthy sample was used to define reference values. The associations between TKV, renal function and CVD risk factors were determined using multivariable logistic regression analysis.
Results:
Overall, mean TKV was 278 ± 54 cm3 for women and 365 ± 66 cm3 for men. Risk factors for high TKV (>90% healthy referent size) were body surface area (BSA), diabetes, smoking and albuminuria, while age, female and estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 were protective. Participants with high TKV had higher odds of diabetes [odds ratio (OR) 2.15, P < 0.001] and lower odds of eGFR <60 mL/min/1.73 m2 (OR 0.32, P = 0.007). Risk factors for low TKV (<10% healthy referent size) were age, female and eGFR <60 mL/min/1.73 m2, while BSA and diabetes were protective. Participants with low TKV had higher odds of eGFR <60 mL/min/1.73 m2 (OR 6.12, P < 0.001) and albuminuria (OR 1.56, P = 0.03).
Conclusions:
Low TKV is associated with markers of kidney damage including albuminuria and eGFR <60 mL/min/1.73 m2, while high TKV is associated with diabetes and decreased odds of eGFR <60 mL/min/1.73 m2. Prospective studies are needed to characterize the natural progression and clinical consequences of TKV.
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