ULTRASONOGRAPHIC EVALUATIONOF RENAL DIMENSIONS OF PREGNANT AND NON-PREGNANT WOMEN IN DELTA STATE

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ABSTRACT

  INTRODUCTION:  The gross structure of the kidney has been   known   to be   related to its function. Hence significance deviations would be expected to affect  the excretions of metabolic waste and production of erythropetin, prostaglandins , and renin necessary for homeostasis. The aim of this research was to determine the normal kidney size and volume  of pregnant and non- pregnant women in Delta State.

METHOD: Ultrasonographic   kidney measurement were performed   on 142   subjects(  pregnant  and non- pregnant women), without no[H1]  renal lesions, with the age range of 18- 57 years.[H2] Measurements  include[H3]  length, width, thickness, and estimation of the renal size was obtained by multiplying the first three variables, and renal volume was obtained by multiplying the first three variables and by dividing by two. The effect of age, body mass index(BMI)  to renal  variables, size and   volume was statistically analysed.

RESULTS   : On the right, the mean renal(length, width, thickness, size, and volume), are 9.48  + 0.86cm,  6.42 + 0.72cm, 3.99 + 0.55cm, 245.42 + 61.55cm³ and 122.71 + 30.77cm ³ . On the left, the mean renal( length, width, thickness, size, and volume), are 9.72 + 0.87cm, 6.64 +0.97cm, 4.54 + 0.87cm, 299.26 + 90.43cm³, and 149.63 +45.21cm³, for non- pregnant women. For pregnant women , on the right  mean renal(length, width, thickness, size, and renal volume) are 9.75 + 0.99cm,  6.68 +0.63cm, 4.22 + 0.50cm,  279.49 +73.95cm³  and 139.97 +  36.94cm³. On the left,  the  mean renal  ( length, width, thickness, size, volume), are9.93 + 1.76cm, 6.63 +0.82cm, 4.82 +0.62cm, 324.52+ 109. 59cm³,  and  162.26 +54.79cm³.

Left renal ( length, width, thickness, size and volume  )  was greater than right (length, width, thickness, size and volume) for pregnant and non- pregnant women.

CONCLUSION:  The  mean  renal size and volume  for pregnant women were greater than non-pregnant women, also there was a slight  correlation to renal size and volume to age and body mass index (BMI).

CHAPTER ONE

INTRODUCTION

1.1     BACKGROUND OF STUDY

The gross structure of the kidney is known to be related to its functions. Hence, significant deviations could be expected to affect the excretion of metabolic wastes and production of erythropoietin, prostaglandins, and renin necessary for homeostasis of the internal milieu (Meyer and Bellucci, 2009). Kidney sizes and function can be affected by age (Meyer and Bellucci, 2009). Also, the kidney sizes of patient are valuable diagnostic parameters in urological and nephrologic practice. Most adult kidney sizes have been described by most authors as 11cm long, 6cm wide, 3cm thick, and weigh 150g (Moore et al, 2010). Further review of literature have showed that renal size varies with age, gender, body mass  index (BMI) and pregnancy. (Shcherbak et al, 2009).

Renal infections, DiabetesMiletus[H4] , hypertension, obesity, and other nephrogic[H5]  disorder are import[H6]  condition affecting renal size (Wianaf et al, 2010). Renal size and function reflect the health status of the kidney.Therefore, a change in renal dimensions is an important sign of renal disease (Baxet al, 2010). Kidney sizes are significantly influenced by congenital anomalities, urinary tract disease, systemic disease, micro and macro vascular disease, and neoplasia (Weisenbechiet al, 2009).

Also during pregnancy, sonographic measurement of renal size, volume and length is important for the evaluation and follow-up of renal pathologies. Most Authors are of the opinion that during pregnancy, there is a change in the sodium and electrolyte regulation and hormonal effect of relaxin which is produced in the kidney during pregnancy (Khatiet al, 2009). The change in renal system is important for the outcome of an index pregnancy (Platt et al, 2008). These changes in renal system are anatomical and physiological, which affect the renal blood flow, the kidney calyces, ureter, bladder and the urethra. Some of the physiological changes which are seen are increase in the renal plasma fluid and the glomerular filtration rate with the corresponding anatomical changes which are seen in the renal volume (Morrafiet al, 2008). Renal volume which is one of the parameters affected by pregnancy is important in accessing the health status of the kidney (Christensinet al, 2010).

Ultrasonography is one of the most important methods used in the estimation of kidney dimensions such as length, width or breadth, thickness and renal volume (Gauelaet al, 2009). Ultrasonography is simple, reliable, non-invasive and reproducible (Brandthet al, 2009). It is safe and has advantage over other radiological imaging modalities such as Conventional radiography and Computed axial tomography (Jerbulamet al, 2007), because it does not utilize ionizing radiations which is harmful to the developing foetus and other radiosensitive organs in the body (Radermacheret al, 2008).

Ultrasonography offers excellent anatomical details, requiresno[H7]  special preparations, is readily available, cheap, and does not expose patients to radiation or contrast agent. Renal ultrasound is used to determine the site or size of the kidney and to detect any focal lesion (Methond T, 2008). It also helps to evaluate pertinent anatomy and pathology especially during pregnancy (Widjajaet al, 2009).

Renal size can be determined by measuring the length, volume, and cortical or thickness [H8] of the kidneys (Kang et al, 2010). Renal size and volume measurement are used frequently as the basis for making clinical decisions.

1. SIGNIFICANCE OF STUDY

• This study will establish the effect of pregnancy on renal size.

Sonographic dimension