[Projectional anatomy of the kidneys in older age groups: comparative analysis of somatotypes.]

The aim of the study was to conduct a comparative analysis of the projection anatomy of the kidneys in older individuals of various somatotypes with the determination of morphometric patterns and topographic and anatomical features to optimize diagnostic and therapeutic measures in geriatric practice. The study was carried out in accordance with the design of a one-stage cross-sectional study with a prospective recruitment of 516 participants aged 45-59 years. Somatotyping was carried out using the modified Heath-Carter method with a comprehensive assessment of endomorphy, mesomorphy and ectomorphy. The main visualization method was multispiral computed tomography with a slice thickness of 0,625-1,25 mm in native mode and with contrast enhancement. For a detailed analysis, specialized 3D Slicer software with automatic segmentation of the renal parenchyma and construction of three-dimensional models was used. Statistical analysis was performed using parametric and nonparametric methods depending on the nature of the data distribution. The results demonstrated statistically significant differences in the projection anatomy of the kidneys between somatotypes. The endomorphic type was characterized by maximum values of the angles of inclination of the renal axis with an average of 10,4±3,2° and a pronounced tendency towards age-related prolapse of the organ. The ectomorphic type demonstrated the greatest stability of anatomical relationships with minimum deviation angles of 7,8±1,9°. Progressive age-related dynamics of the angular parameters of the inclination of the renal axis was established with an increase in average values from 8,3±2,1° in mature age to 11,2±3,4° in old age. Significant gender differences in the nature of age-related changes were revealed with greater stability of morphometric parameters in men and more pronounced age-related transformation in women. The established morphometric patterns substantiate the need to take into account somatotypical features when interpreting radiation diagnostic data and planning surgical interventions in patients of older age groups. The results obtained can serve as a basis for developing personalized approaches to the diagnosis and treatment of urinary system diseases, taking into account the individual typological characteristics of the body.