Clinical associations of total kidney volume: the Framingham Heart Study.
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.
National Heart, Lung and Blood Institute, Framingham Heart Study, Framingham, MA, USA.
Daniel A
DA
Roseman
National Heart, Lung and Blood Institute, Framingham Heart Study, Framingham, MA, USA.|Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, MD, USA.
Shih-Jen
SJ
Hwang
Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan.
Noriko
N
Oyama-Manabe
National Heart, Lung and Blood Institute, Framingham Heart Study, Framingham, MA, USA.|Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Michael L
ML
Chuang
National Heart, Lung and Blood Institute, Framingham Heart Study, Framingham, MA, USA.|Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, MD, USA.|Cardiology Section, Veterans Affairs Boston Healthcare System, Boston, MA, USA.
Christopher J
CJ
O'Donnell
Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.|Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Warren J
WJ
Manning
National Heart, Lung and Blood Institute, Framingham Heart Study, Framingham, MA, USA.|Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, MD, USA.|Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Caroline S
CS
Fox
D000368:Aged; D000419:Albuminuria / Q000209:etiology / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000150:complications*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007674:Kidney Diseases / Q000209:etiology / Q000473:pathology*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors
albuminuria; cardiovascular disease risk factors; chronic kidney disease; magnetic resonance imaging; total kidney volume