title: Left Renal Cortical Thickness Measured by Ultrasound Can Predict Early Progression of Chronic Kidney Disease.
abstract: OBJECTIVE
  The kidney becomes atrophic in advanced chronic kidney disease, and renal size and parenchymal volume correlate with renal function. However, alterations in renal parenchymal volume have not been adequately studied in terms of the renal cortex and medulla. We investigated the relationship between the changes in the renal cortex and medulla and renal function.
  
  
  METHODS
  Renal ultrasound (US) parameters including renal length, parenchymal thickness, cortical thickness and medullary thickness were assessed in 176 subjects, who were categorized into 4 groups based on the estimated glomerular filtration rate (ml/min/1.73 m2): group 1, ≥ 90; group 2, ≥ 60 but < 90; group 3, ≥ 30 but < 60; and group 4, < 30. Renal US parameters in both kidneys were compared among the 4 groups.
  
  
  RESULTS
  We found stepwise associations in renal length, cortical thickness and parenchymal thickness with decreased renal function. Medullary thickness showed no changes among groups 1-3. Multiple linear regression analysis including sex, age and renal US parameters showed that only renal length was an independent predictor of renal function. When analyzed in groups 1-3, cortical thickness was the strongest associated parameter. Lower cortical left/right ratio (left cortical thickness/right cortical thickness) showed a stepwise association with a decrease in renal function.
  
  
  CONCLUSIONS
  Renal length and cortical thickness measured by US were correlated with renal function. In particular, left cortical thickness could help to detect early changes in renal function.
authors.affiliation: Division of Medicine and Clinical Science, Tottori University Faculty of Medicine, Tottori, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Takata
authors.forename: Masahiko
authors.initials: M
authors.lastname: Koda
authors.forename: Takaaki
authors.initials: T
authors.lastname: Sugihara
authors.forename: Shinobu
authors.initials: S
authors.lastname: Sugihara
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Okamoto
authors.forename: Kenichi
authors.initials: K
authors.lastname: Miyoshi
authors.forename: Masanori
authors.initials: M
authors.lastname: Hodotsuka
authors.forename: Yuki
authors.initials: Y
authors.lastname: Fujise
authors.forename: Tomomitsu
authors.initials: T
authors.lastname: Matono
authors.forename: Junichi
authors.initials: J
authors.lastname: Okano
authors.forename: Keiko
authors.initials: K
authors.lastname: Hosho
authors.forename: Takuji
authors.initials: T
authors.lastname: Iyama
authors.forename: Takeaki
authors.initials: T
authors.lastname: Fukui
authors.forename: Satoko
authors.initials: S
authors.lastname: Fukuda
authors.forename: Chishio
authors.initials: C
authors.lastname: Munemura
authors.forename: Hajime
authors.initials: H
authors.lastname: Isomoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007672:Kidney Cortex / Q000000981:diagnostic imaging*; D007677:Kidney Function Tests; D007679:Kidney Medulla / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D051436:Renal Insufficiency, Chronic / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D055815:Young Adult