Kidney Size in Malnourished Children

Abstract

BACKGROUND Malnourished children can suffer from various problems including sepsis, pneumonia, tuberculosis, gastroenteritis, vitamin A deficiency and very significantly growth failure. Malnutrition is a leading cause of stunting in under five years group of children in developing world. As stunting is visible but other parameters may remain unrecognized because of low importance in a busy paediatric ward or outpatient department (OPD) management activities. It includes growth of many organs including kidney. Under-nutrition affects more than several lakhs of children in the underdeveloped world like India. Among various factors which determine growth, nutrition is one of the most important factors that determine growth and size of the human body in childhood. Malnutrition can affect both renal growth and function of the kidney especially if it is seen in the first eighteen months of life as growth of nephron continues till two years of life though the formation of nephron is almost complete by term pregnancy. We wanted to study the size of kidney in malnourished children. METHODS In the study, 72 under nourished children were included as per inclusion criteria (according to WHO classification of malnutrition) from 01.06.2017 to 31.05.2018. Detailed anthropometric measurements were done and ultrasound kidney, ureter and bladder (KUB) was done for each case. RESULTS It has been seen that maximum number of children (68.06%) had severe malnutrition. Decreased kidney size was found in 34 (47.22%) cases. It was found that there was significant difference in kidney size between moderate and severe malnutrition (p=0.003). Significantly, there was no major difference in kidney parameters (length and width) between male and female as p value > 0.05. All measurements of right kidney were found to be lower than those of the left kidney, but no significant difference was found in size between right and left kidney. CONCLUSIONS There was no significant difference of kidney size between male and female (p>0.05). But there was significant difference of kidney parameters between severe and moderate malnutrition (p<0.05) and kidney size is best correlated with their length/height (r=0.5686). Hence it is always to be remembered that severity of malnutrition can affect the growth of kidney especially in under-five children which may have a connection to some of the chronic morbid conditions like hypertension, chronic kidney disease and end stage renal disease in later part of life.