Lower kidney volume leads to increased risk of CKD

Photo credit: Mohammed Haneefa Nizamudeen

Below you will find a summary of “Kidney volume and risk of incident kidney outcomes,” published in the June 2024 issue of Nephrology by Wu et al.

Low total kidney volume (TKV) increases the risk of chronic kidney disease (CKD).

Researchers conducted a prospective study examining the nonlinear associations, incidence, causes, and added value of low TKV beyond traditional kidney health markers.

They used a TKV, height-adjusted TKV, and body surface area-adjusted TKV (BSA-TKV) from 34,595 white British participants in the UK Biobank to examine TKV, height-adjusted TKV, and BSA-TKV. Cox models assessed associations with CKD, AKI, and cardiovascular events. CKD prognostic thresholds were determined using a modified Mazumdar method. Two-sample Mendelian randomization tested genetic associations.

The results showed that after adjusting for eGFR and albuminuria, a 10 ml lower TKV was associated with a 6% higher risk of CKD (HR 1.06, 95% CI: 1.03 to 1.08, P=5.8×10^-6), but not AKI (HR 1.00, 95% CI: 0.98 to 1.02, P=0.66). In addition, BSA-TKV or prognostic thresholds are at 119 (10th percentile) and 145 mL/m² (50th percentile) improved the accuracy of CKD risk. Mendelian randomization showed a 10% higher CKD risk with a 10 ml lower genetically predicted TKV (OR 1.10, 95% CI: 1.06 to 1.14, P=1.3×10^-7) and a 2-fold increased risk of CKD with a 7.88 ml lower TKV (95% CI: -9.81 to -5.95, P=1.2×10^-15). No cardiovascular associations were found in TKV.

The researchers concluded that kidney volume predicts CKD risk independently of traditional factors such as eGFR and albuminuria, and found a reciprocal relationship between kidney volume and CKD through Mendelian randomization.

Source: journals.lww.com/jasn/abstract/9900/kidney_volume_and_risk_of_incident_kidney_outcomes.349.aspx