Associations of MRI-derived kidney volume, kidney function, body composition and physical performance in ≈38 000 UK Biobank participants: a population-based observational study

Jeong Min Cho; Jung Hun Koh; Seong Geun Kim; Soojin Lee; Yaerim Kim; Semin Cho; Kwangsoo Kim; Yong Chul Kim; Seung Seok Han; Hajeong Lee; Jung Pyo Lee; Kwon Wook Joo; Chun Soo Lim; Yon Su Kim; Dong Ki Kim; Sehoon Park

doi:10.1093/ckj/sfae068

Associations of MRI-derived kidney volume, kidney function, body composition and physical performance in ≈38 000 UK Biobank participants: a population-based observational study

Clin Kidney J. 2024 Mar 15;17(4):sfae068. doi: 10.1093/ckj/sfae068. eCollection 2024 Apr.

Authors

Jeong Min Cho^{1

2}, Jung Hun Koh^{1

3}, Seong Geun Kim⁴, Soojin Lee^{5

6}, Yaerim Kim⁷, Semin Cho², Kwangsoo Kim⁸, Yong Chul Kim^{3

6}, Seung Seok Han^{3

6

9}, Hajeong Lee^{3

6}, Jung Pyo Lee^{6

9

10}, Kwon Wook Joo^{3

6

9}, Chun Soo Lim^{6

9

10}, Yon Su Kim^{3

6

9

11}, Dong Ki Kim^{3

6

9}, Sehoon Park³

Affiliations

¹ Department of Translational Medicine, Seoul National University College of Medicine, Seoul, Korea.
² Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Gyeonggi-do, Korea.
³ Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
⁴ Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea.
⁵ Department of Internal Medicine, Uijeongbu Eulji University Medical Center, Uijeongbu, Korea.
⁶ Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
⁷ Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
⁸ Transdisciplinary Department of Medicine & Advanced Technology, Seoul National University Hospital, Seoul, Korea.
⁹ Kidney Research Institute, Seoul National University, Seoul, Korea.
¹⁰ Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
¹¹ Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea.

Abstract

Background: Kidney volume is used as a predictive and therapeutic marker for several clinical conditions. However, there is a lack of large-scale studies examining the relationship between kidney volume and various clinicodemographic factors, including kidney function, body composition and physical performance.

Methods: In this observational study, MRI-derived kidney volume measurements from 38 526 UK Biobank participants were analysed. Major kidney volume-related measures included body surface area (BSA)-adjusted total kidney volume (TKV) and the difference in bilateral kidneys. Multivariable-adjusted linear regression and cubic spline analyses were used to explore the association between kidney volume-related measures and clinicodemographic factors. Cox or logistic regression was used to identify the risks of death, non-kidney cancer, myocardial infarction, ischaemic stroke and chronic kidney disease (CKD).

Results: The median of BSA-adjusted TKV and the difference in kidney volume were 141.9 ml/m² [interquartile range (IQR) 128.1-156.9] and 1.08-fold (IQR 1.04-1.15), respectively. Higher BSA-adjusted TKV was significantly associated with higher estimated glomerular filtration rate {eGFR; β = 0.43 [95% confidence interval (CI) 0.42-0.44]; P < .001}, greater muscle volume [β = 0.50 (95% CI 0.48-0.51); P < .001] and greater mean handgrip strength [β = 0.15 (95% CI 0.13-0.16); P < .001] but lower visceral adipose tissue volume [VAT; β = -0.09 (95% CI -0.11 to -0.07); P < .001] in adjusted models. A greater difference in bilateral kidney volumes was associated with lower eGFR, muscle volume and physical performance but with higher proteinuria and VAT. Higher BSA-adjusted TKV was significantly associated with a reduced risk of CKD [odds ratio (OR) 0.7 (95% CI 0.63-0.77); P < .001], while a greater difference in kidney volume was significantly associated with an increased risk of CKD [OR 1.13 (95% CI 1.07-1.20); P < .001].

Conclusion: Higher BSA-adjusted TKV and lower differences in bilateral kidney volumes are associated with higher kidney function, muscle volume and physical performance and a reduced risk of CKD.

Keywords: chronic kidney failure; glomerular filtration rate; kidney function tests; magnetic resonance imaging; organ size.