31 Weeks Pregnant Baby Whaw Normal Kidny Size

Pediatr Nephrol. 2010; 25(ii): 289–298.

Kidney growth curves in healthy children from the third trimester of pregnancy until the age of ii years. The Generation R Study

J. J. Miranda Geelhoed,^{1, ii, iii} H. Rob Taal,^{1, 2, 3} Eric A. P. Steegers,⁴ Lidia R. Arends,^{five, six} Maarten Lequin,⁷ Henriëtte A. Moll,ⁱⁱⁱ Albert Hofman,² Albert J. van der Heijden,^three and Vincent W. V. Jaddoe ^{1, ii, 3}

J. J. Miranda Geelhoed

^aneThe Generation R Report Group (AE-006), Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, Holland

^twoDepartment of Epidemiology, Erasmus Medical Center, Rotterdam, The netherlands

³Department of Pediatrics, Erasmus Medical Heart, Rotterdam, Kingdom of the netherlands

H. Rob Taal

¹The Generation R Report Grouping (AE-006), Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands

^twoSection of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands

³Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands

Eric A. P. Steegers

^fourDepartment of Obstetrics & Gynecology, Erasmus Medical Heart, Rotterdam, The Netherlands

Lidia R. Arends

^vDepartment of Biostatistics, Erasmus Medical Center, Rotterdam, Holland

^half-dozenDepartment of Psychology, Erasmus Medical Centre, Rotterdam, The Netherlands

Maarten Lequin

^sevenSection of Radiology, Erasmus Medical Centre, Rotterdam, The Netherlands

Henriëtte A. Moll

ⁱⁱⁱDepartment of Pediatrics, Erasmus Medical Middle, Rotterdam, Holland

Albert Hofman

²Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands

Albert J. van der Heijden

³Department of Pediatrics, Erasmus Medical Heart, Rotterdam, The Netherlands

Vincent W. V. Jaddoe

¹The Generation R Study Group (AE-006), Erasmus Medical Eye, P.O. Box 2040, 3000 CA Rotterdam, The netherlands

²Department of Epidemiology, Erasmus Medical Centre, Rotterdam, Holland

³Section of Pediatrics, Erasmus Medical Center, Rotterdam, Holland

Received 2009 Jul 31; Revised 2009 Sep 2; Accepted 2009 Sep xvi.

Abstract

Information about growth of kidney structures in early life is limited. In a population-based prospective cohort study, from foetal life onwards, we constructed reference curves for kidney growth from the third trimester of pregnancy until early childhood, using information from 1,158 salubrious children. Kidney size, defined equally length, width, depth and volume, was measured in the third trimester of pregnancy and at the postnatal ages of 6 months and 24 months. Analyses were based on more than 2,500 kidney measurements. In the third trimester of pregnancy and at 6 months of age all kidney measurements were larger in boys than in girls. At 24 months of age, these gender differences were simply pregnant for left kidney structures and correct kidney length. Both groups showed trends towards smaller left kidney measurements than right kidney measurements at all ages. Gender-specific reference curves based on postal service-conceptional and postnatal ages were constructed for left and right kidney length, width, depth and volume. We concluded that kidney size is influenced by age and gender. Left kidney size tended to be smaller than right kidney size, except for kidney length. The reference curves can be used for assessing kidney structures past ultrasound in foetal life and early childhood.

Electronic supplementary material

The online version of this commodity (doi:10.1007/s00467-009-1335-2) contains supplementary textile, which is available to authorised users.

Keywords: Kidney dimensions, Reference growth curves, Children, Ultrasound, Gender

Introduction

Assessment of kidney size in children is of import for clinical and epidemiological studies. Aberrant early kidney development may take perinatal and neonatal consequences [1]. Smaller foetal kidney size has likewise been suggested to be related to hypertension and renal disease in adulthood [2, 3]. Recently, nosotros showed in the aforementioned accomplice that small kidney size in foetal life tends to persist in early on babyhood. Furthermore, maternal anthropometric characteristics, foetal biometric data and claret flow patterns were associated with kidney size in babyhood. Higher growth rates in early childhood were positively associated with combined kidney volume [four]. These results suggest that variations in foetal and early postnatal exposure and growth might take persistent consequences for kidney size. Kidney size can be measured non-invasively and efficiently with ultrasound. Few studies have published reference ranges for kidney size in good for you children during foetal and neonatal life [5, 6]. One report showed reference data on postnatal kidney growth from nascency to eighteen months of age [7]. Previous studies were based on the characteristics of postnatal kidney growth and focused generally on kidney volume in relation to weight, superlative or body surface area. Recently, new reference centiles were generated to assess kidney size of children with 'single kidneys' to identify those patients with unfavourable courses and relevant single kidney growth impairment [8]. Currently, there are no studies that accept evaluated normal kidney growth from late foetal life to early childhood. This perinatal period may be of importance in the identification of aberrant kidney size and growth, with subsequent short-term and long-term clinical consequences [9, 10].

Therefore, the aim of this study was to construct reference curves for kidney structures including kidney length, width, depth and volume in children from the third trimester of pregnancy until the postnatal age of 24 months in a population-based cohort.

Methods

Written report design

This written report was embedded in the Generation R Study, a population-based prospective cohort study from foetal life until immature machismo in Rotterdam, Holland [11, 12]. Detailed assessments of foetal and postnatal growth and development were conducted in a subgroup of ane,232 mothers and their children [11, 12]. In this subgroup foetal kidney ultrasounds were performed in the third trimester of pregnancy (gestational historic period 30 weeks) and postnatal kidney ultrasounds were performed at the ages of 6 months and 24 months. The study was approved by the Medical Ideals Committee of the Erasmus MC, Rotterdam. Written informed consent was obtained from all participants.

Population for analysis

In total, ane,232 women were enrolled in the Focus cohort. The assay was limited to singleton live-built-in infants (due north = 1,215) whose mothers had participated in the third trimester measurements. Twin pregnancies (n = 15) and pregnancies leading to perinatal death (due north = 2) were excluded from the assay. Kidney ultrasounds were successfully performed in 95% (n = 1,158) of these subjects. Of the initial 1,215 singleton live-born infants, 74% (n = 901) and seventy% (due north = 856) underwent postnatal assessment at the ages of 6 months and 24 months, respectively. Kidney ultrasounds were successfully performed in 83% (n = 747) and 80% (n = 683) of these infants, respectively. Missing values were mainly due to the infants crying or to the unavailability of equipment or radiographer. Infants who had undergone a postnatal kidney ultrasound at the ages of 6 months and 24 months did non differ from the postnatal non-responders in foetal and birth characteristics. At that place were no kidney or ureterovesical anomalies other and so mild pyelectasis over ten mm (n = 3) in our study population. In total, analyses were based on more than than 2,500 kidney measurements. The numbers of kidney growth measurements available for the analyses are shown in Table1.

Table 1

Numbers of successful measurements per variable, according to age. Values are percentages (absolute number of children)

Kidney measurement	Successful measurements, % (n)
	Gestational age 30 weeks	Age 6 months	Historic period 24 months
	(n = 1,215)	(n = 901)	(n = 856)
Left kidney
Length	94.ix (i,153)	81.two (732)	78.2 (669)
Width	95.2 (1,157)	77.two (696)	72.8 (623)
Depth	95.one (1,155)	76.8 (692)	76.9 (624)
Volume	94.4 (1,147)	76.6 (690)	72.9 (615)
Right kidney
Length	94.7 (ane,151)	82.nine (747)	81.nine (701)
Width	95.iv (i,159)	82.4 (742)	80.vi (690)
Depth	95.4 (one,159)	82.2 (741)	80.vi (690)
Book	94.5 (one,148)	82.1 (740)	lxxx.4 (688)

Ultrasound measurements

Gestational age was established by foetal ultrasound. Crown–rump length was used for pregnancy dating until a gestational age of 12 weeks and v days (crown–rump length smaller than 65 mm), and biparietal diameter was used for pregnancy dating thereafter (gestational age from 12 weeks and 5 days onwards, biparietal diameter larger than 23 mm) [13].

Foetal left and right kidneys were measured in the third trimester of pregnancy with an ATL-Philips HDI 5000 instrument (Seattle, WA, USA) equipped with a 2.0–v.0 MHz curved array transducer. In a sagittal plane the maximum longitudinal kidney length was measured, with the calipers placed on the outer edges of the caudal and cranial sides. Antero-posterior (kidney width) and transverse (kidney depth) diameters were measured perpendicular to each other, outer to outer, in an axial plane [xiv]. Values of maximum bipolar kidney length, width and depth were obtained from both the left and right kidneys. Kidney width and depth were measured at the level of the kidney hilum [14, 15]. The images were magnified to ensure optimal measurements [xiv]. Foetal growth characteristics (head circumference, belly circumference, femur length) were measures at the same visit, and foetal weight was estimated [13].

Postnatally, two-dimensional ultrasounds of the kidneys were performed in children at the ages of 6 months and 24 months. The examination was carried out in a quiet room with the kid quietly awake in a supine position. This position was standardised to prevent differences resulting from position [14, 15]. Mean length, width and depth were calculated equally the boilerplate of 3 measurements and used for data assay. Foetal and postnatal kidney volumes were both calculated in cubic centimetres using the equation of an ellipsoid: [15, 16]. The infants' anthropometric parameters, including weight and length, were all measured at the ages of 1.5 months, six months and 24 months. Date of nascency, nascency weight and gender were obtained from midwife and hospital registers.

For the foetal ultrasound measurements, intra- and interobserver studies showed the intraclass correlation coefficient (ICC) to be higher than 0.98 and the corresponding coefficients of variation (CV) to be lower than 6%. Bland and Altman plots to test agreement of measurements demonstrated 95% limits of agreement to be within 10% difference from the mean of measurements, indicating good reproducibility [17]. For the postnatal ultrasound measurements, the intra-observer ICCs ranged from 0.93 (left and right renal widths and right renal thickness) to 0.99 (left renal length), and interobserver ICCs ranged from 0.64 (right renal thickness) to 0.xc (correct renal length). Limits of agreement in the Banal and Altman plots ranged from −8.0% to 9.ii% (intra-observer left renal width) to the widest limit from −18.0% to 19.2% (interobserver left renal length) [18].

Data analysis

Differences in foetal and postnatal characteristics between boys and girls were assessed past t-tests and chi-square tests for independent samples. Differences betwixt left and right kidney were tested with paired-samples t-tests.

Data were analysed as recommended by Altman and Chitty [19] and Royston and Altman [xx]. For the reference curves for kidney growth, post-conceptional age was plotted against kidney length, width, depth and volume. From the original data, measurements of more than than ii standard deviations (SDs) from the regression line, fitted on our data, were considered to exist outliers (n = 10) and were therefore removed. They were probably a consequence of measurement error or a data entry mistake. The all-time-plumbing fixtures curves were determined by 2nd-caste partial polynomials [21]. Nosotros fitted the curves, using repeated measurement analyses and taking into account the dependency in the data by specifying a constant covariance between measurements of the same subject [20, 22]. The all-time-fitting partial polynomial curves were chosen past our comparing the deviances, by Akaike's information criterion, and past our visually checking the goodness of fit. Next, regression lines were fitted for the dependency of the residual SD on conceptional age [23]. After, we plotted the SD scores against conceptional age to assess the correctness of the model.

Finally, centiles were derived and the curves were plotted on the data. The median age of 2-year-old children visiting the research centre was 25 months (95% range 23.6–28.3 months). Since only 34 children had undergone measurement across the postnatal historic period of 28 months (160 weeks afterwards formulation), the results are presented upwards to the postnatal historic period of 28 months. Reference curves for kidney growth were constructed for a post-conceptional age from 30 weeks to 160 weeks, corresponding to a gestational age of thirty weeks and a postnatal age of 28 months.

All statistical analyses were performed with the Statistical Bundle for the Social Sciences, version 15.0, for Windows (SPSS Inc, Chicago, IL, Usa) and the Statistical Analysis Organisation (SAS) for Windows, version 9.one.3.

Results

The pct of boys was 52% (Table2). The overall median historic period at the third trimester of pregnancy was 30 weeks of gestation (full range 27.one–35.1 weeks). The overall median historic period of the infants at their 6-month postnatal visit was 6.3 months (full range 5.1–11.0 months), and at their 24-month postnatal visit it was 25.1 months (total range 21.half-dozen–31.6 months). Head circumference at the third trimester and postnatal weight and length at the ages of 6 months and 24 months were larger in boys than in girls (all P values <0.001). No divergence was found for gestational age at nascence betwixt boys and girls. In total, fifteen children in our study group were built-in with a small size for gestational age [<−2 standard divergence scores (SDS)], 18 children had a low birth weight (<2,500 g) and 23 children were born before term (gestational age <37 weeks). Table3 shows that in the 3rd trimester of pregnancy and at the historic period of 6 months all kidney measurements were larger in boys than in girls. At the age of 24 months, these gender differences were merely significant for left kidney structures and correct kidney length. Both groups showed trends towards smaller left kidney measurements than right kidney measurements at all ages (Table4).

Table 2

Subjects' characteristics. Differences between boys and girls were compared by contained-samples t-tests or by Χ² tests. Values are means (standard divergence), medians (95% range) or percentages

Characteristic	Boys	Girls	P
At the third trimester	(due north = 603)	(northward = 555)
Gestational historic period (weeks)	30.four (28.seven–32.viii)	30.three (28.2–32.five)	0.05
Caput circumference (cm)	28.eight (1.2)	28.3 (1.one)	<0.001
Belly circumference (cm)	26.seven (one.7)	26.5 (1.half-dozen)	0.2
Femur length (cm)	5.7 (0.3)	5.8 (0.three)	0.2
Estimated fetal weight (k)	1,632 (264)	1,623 (252)	0.vii
At birth	(northward = 603)	(north = 555)
Gestational historic period (weeks)	40.iii (36.two–42.4)	twoscore.3 (36.i–42.iv)	0.ix
Gestational historic period <37 weeks (%)	12 (3.four)	xi (3.iii)	0.9
Weight (chiliad)	iii,557 (518)	3,488 (506)	0.05
Birth weight <2,500 chiliad (%)	8	10	0.6
Pocket-sized for gestational historic period (%)	6	9	0.iv
At half-dozen months	(n = 379)	(n = 368)
Historic period at visit (months)	6.3 (five.4–8.0)	six.iii (v.4–8.two)	0.7
Weight at visit (g)	8,173 (837)	7,640 (807)	<0.001
Length at visit (cm)	69.four (2.four)	67.9 (2.four)	<0.001
At 24 months	(n = 333)	(north = 350)
Age at visit (months)	25.1 (23.6–28.0)	25.2 (23.4–28.three)	0.3
Weight at visit (yard)	12,890 (1,395)	12,429 (1,343)	<0.001
Length at visit (cm)	89.6 (3.2)	88.iv (3.3)	<0.001

Table 3

Differences between boys and girls stratified for left and right kidney structures. Differences between boys and girls were compared by independent-samples t-tests. Values are means (95% range)

Kidney measurement	Left kidney			Right kidney
	Boys	Girls	P	Boys	Girls	P
Gestational age thirty weeks	(n = 604)	(northward = 553)		(northward = 603)	(n = 556)
Length (mm)	39.five (32.0–47.0)	38.iv (32.7–45.0)	<0.001	39.vi (32.0–46.6)	38.five (32.2–45.iii)	<0.001
Width (mm)	21.6 (17.0–28.0)	21.1 (16.5–26.0)	0.001	22.4 (17.0–28.0)	22.0 (17.0–27.6)	0.02
Depth (mm)	22.7 (17.0–29.0)	22.one (17.nine–27.8)	0.001	23.2 (17.8–30.0)	22.ix (xviii.0–29.0)	0.03
Volume (cmiii)	ten.3 (v.4–17.9)	9.5 (five.4–15.0)	<0.001	11.0 (v.eight–18.five)	ten.three (5.8–16.viii)	<0.001
Age six months	(n = 375)	(north = 358)		(northward = 379)	(n = 368)
Length (mm)	60.1 (48.vi–seventy.iv)	58.six (fifty.0–67.4)	<0.001	58.8 (49.7–69.three)	57.5 (49.5–67.six)	<0.001
Width (mm)	28.2 (22.three–36.4)	27.6 (21.6–35.7)	0.01	28.0 (21.8–35.4)	27.v (21.4–36.5)	0.04
Depth (mm)	26.v (20.1–33.0)	25.five (20.2–32.ii)	<0.001	27.8 (21.3–34.9)	27.0 (20.9–34.0)	0.001
Volume (cm3)	23.8 (xiv.0–36.half-dozen)	21.9 (13.ix–33.4)	<0.001	24.0 (15.iii–35.6)	22.iv (xiv.2–34.6)	<0.001
Age 24 months	(n = 330)	(n = 318)		(north = 347)	(n = 336)
Length (mm)	66.8 (56.1–lxxx.three)	65.seven (53.7–78.0)	0.03	65.2 (54.8–76.6)	64.3 (53.2–76.5)	0.04
Width (mm)	xxx.8 (25.6–37.1)	30.i (23.five–37.8)	0.01	30.7 (25.6–38.0)	xxx.half dozen (25.two–37.ane)	0.61
Depth (mm)	30.9 (24.8–38.9)	30.1 (24.2–38.1)	0.002	32.0 (25.v–39.4)	31.9 (25.9–39.6)	0.79
Book (cmthree)	33.6 (22.8–51.half dozen)	31.viii (nineteen.3–52.ii)	0.004	33.8 (22.9–53.3)	33.one (22.i–49.2)	0.19

Tabular array 4

Differences between left and right kidney structures stratified for gender. Differences betwixt left and correct kidney structures were compared using paired-samples t-tests. Values are means (95% range)

Kidney measurement	Boys			Girls
	Left kidney	Right kidney	P	Left kidney	Right kidney	P
Gestational age 30 weeks	(due north = 604)	(n = 603)		(n = 553)	(n = 556)
Length (mm)	39.5 (32.0–47.0)	39.half-dozen (32.0–46.6)	0.79	38.iv (32.seven–45.0)	38.5 (32.2–45.3)	0.45
Width (mm)	21.6 (17.0–28.0)	22.four (17.0–28.0)	<0.001	21.1 (sixteen.5–26.0)	22.0 (17.0–27.6)	<0.001
Depth (mm)	22.7 (17.0–29.0)	23.ii (17.8–xxx.0)	<0.001	22.one (17.ix–27.8)	22.nine (xviii.0–29.0)	<0.001
Volume (cmthree)	x.three (5.4–17.9)	eleven.0 (v.8–18.5)	<0.001	nine.5 (5.iv–15.0)	x.3 (5.8–16.8)	<0.001
Age 6 months	(n = 375)	(due north = 379)		(north = 358)	(n = 368)
Length (mm)	60.1 (48.6–70.four)	58.8 (49.vii–69.iii)	<0.001	58.6 (50.0–67.four)	57.5 (49.five–67.6)	<0.001
Width (mm)	28.2 (22.3–36.4)	28.0 (21.viii–35.4)	0.fifty	27.half dozen (21.6–35.7)	27.five (21.4–36.5)	0.72
Depth (mm)	26.five (20.1–33.0)	27.eight (21.3–34.9)	<0.001	25.5 (20.2–32.2)	27.0 (20.9–34.0)	<0.001
Volume (cm3)	23.viii (14.0–36.6)	24.0 (15.3–35.6)	0.35	21.9 (13.9–33.4)	22.iv (fourteen.ii–34.half dozen)	0.06
Age 24 months	(n = 330)	(due north = 347)		(due north = 318)	(n = 336)
Length (mm)	66.8 (56.1–80.iii)	65.2 (54.8–76.vi)	<0.001	65.7 (53.7–78.0)	64.3 (53.ii–76.5)	<0.001
Width (mm)	thirty.eight (25.half dozen–37.i)	thirty.7 (25.6–38.0)	0.68	30.one (23.five–37.8)	thirty.half-dozen (25.two–37.ane)	0.02
Depth (mm)	thirty.9 (24.8–38.ix)	32.0 (25.5–39.4)	<0.001	thirty.one (24.2–38.1)	31.9 (25.9–39.6)	<0.001
Volume (cm3)	33.half-dozen (22.8–51.6)	33.8 (22.ix–53.iii)	0.30	31.8 (19.3–52.two)	33.ane (22.one–49.2)	<0.001

Reference curves for private measurements of kidney growth and fitted centiles are given in Fig.ane. Formulae for growth reference curves describing the hateful with the corresponding standard deviation are given in Table5. Standard deviation increased linearly with gestational age. Reference values for kidney length, width, depth and volume are given in the Appendix (Tables 1S–4S).

Reference growth curves of right and left kidney length, width, depth and volume in boys and girls, according to post-conceptional age. a Left kidney length, b right kidney length, c left kidney width, d right kidney width, due east left kidney depth, f correct kidney depth, g left kidney volume, h right kidney volume. Gender-differentiated growth curves for left and right kidney length, with, depth and volume measurements in relation to post-conceptional historic period with 3rd and 97th fitted centiles. The straight lines represent boys and the dotted lines stand for girls

Table 5

Reference curves for kidney structures: equations for the mean and SD of each measurement, based on age in exact weeks. Gender = 0 for boys and gender = i for girls. Age defined as post-conceptional age (weeks)

Discussion

We constructed gender-specific reference growth curves for kidney length, width, depth and volume using measurements from a large population-based prospective accomplice study of healthy children followed from foetal life until early childhood. We observed differences in kidney structures between left and right kidneys and boys and girls.

The major forcefulness of our report is its prospective design from foetal life and the size of the population-based cohort. Our reference curves were based on more than two,500 kidney measurements. To our noesis, no previous studies that focused on kidney size in early life were based on such large numbers. All foetal ultrasounds were carried out by two sonographers, and 86% of all postnatal ultrasounds were performed by 1 trained sonographer [24]. A limitation could exist that in all children participating in the Generation R measurements at the ages of half dozen months and 24 months, kidney measurements were successfully performed in 83% and 80% of these infants, respectively. Missing values were mainly due to the infants crying or to the unavailability of equipment or radiographer. Our results would accept been biased if the subjects' characteristics had differed between those included and those not included in the analyses. However, we observed no differences in growth and foetal kidney characteristics betwixt the subjects that had undergone postnatal kidney measurement and those that had not. Another limitation could be that the report was performed in a healthy population-based cohort study. The selection towards a salubrious population in our cohort might lead to a limited generalisability to preterm children or to children that were pocket-sized for gestational historic period at nascence. These numbers were too modest to be assessed in further detail.

In the third trimester of pregnancy and at the age of vi months all kidney measurements were larger in boys than in girls. At the historic period of 24 months, these gender differences were only significant for left kidney structures and correct kidney length. Several studies of healthy neonates and adults have too shown that male person subjects take larger kidneys than those of female person subjects [25, 26]. One caption for this finding might be a growth-stimulating effect of androgens, or Y-chromosome-related genes. Another explanation could be that during foetal life testosterone levels are significantly higher in boys than in girls [27, 28].

Previously published data accept shown conflicting results concerning differences between left and right kidney size. Some studies found no difference [29, thirty], whereas others accept suggested the left kidney to be larger [31, 32]. Near consequent findings take been reported for kidney length, for which the left kidney seems to be longer than the right [7, 25, 26, 31, 33]. We found that the left kidney was longer in both boys and girls at the postnatal ages of 6 months and 24 months. In foetal life we found no significant departure betwixt left and right kidney length.

Kidney growth is fastest during foetal life and early infancy, and the rate of increase gradually slows through the remainder of the first yr of life and finally stabilises [34]. In our study numbers and curves for the third centiles showed decreasing kidney book at older ages, from 140 weeks and onwards. The decreasing numbers are due to wider ranges, because of the low number of children with visits effectually 140 weeks and onwards. To deal with non-linear kidney growth, some sonographic standards, including means and standard deviations, for kidney size in relation to age accept been published [34–36]. A few other studies created linear or non-linear polynomial regression equations for kidney size during the first yr of life [29, 33]. One study created reference material for kidney size in good for you children beyond the neonatal menstruation [7]. The authors only focused on kidney volume in relation to weight, height and trunk expanse and did not report data about prenatal kidney growth. To our knowledge, our study is the start to provide prospective longitudinal reference material for kidney size that covers the whole period from foetal life to infancy in a salubrious population.

In conclusion, kidney size differed between boys and girls from the age of 30 weeks of pregnancy until 24 months of historic period. The left kidney tended to be smaller than the right kidney. At the historic period of 24 months, the differences in right kidney size between boys and girls were attenuated. Gender-differentiated reference growth curves for both left and correct kidneys were constructed for kidney length, width, depth and volume. These reference curves may be of importance in the identification of abnormal kidney size and growth, with possible subsequent clinical consequences.

Electronic supplementary material

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Acknowledgements

The Generation R Study was conducted past the Erasmus Medical Center in close collaboration with the School of Law and the Faculty of Social Sciences at the Erasmus Academy, Rotterdam, the Municipal Health Service, Rotterdam area, the Rotterdam Homecare Foundation, and the Stichting Trombosedienst & Artsenlaboratorium Rijnmond (STAR), Rotterdam. We gratefully acknowledge the contribution of full general practitioners, hospitals, midwives and pharmacies in Rotterdam.

The kickoff phase of the Generation R Report was fabricated possible by financial support from the Erasmus Medical Center, Rotterdam, the Erasmus University, Rotterdam, and kingdom of the netherlands Organization for Health Research and Development (ZonMw). Boosted back up was provided by a grant from the Dutch Kidney Foundation (C08.2251).

The authors declare that they have no personal or financial conflicts of interest.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7811527/