Sektion Nephrologie, Klinikum do Universität Heidelberg, Heidelberg, Germany
Correspondence and offprint requests to: Prof. E. Ritz, Sektion Nephrologie, Med. Universitätsklinik, Bergheimer Str 56a, D-69115 Heidelberg, Germany.
During each sonographic examination the following measurements should be obtained: maximal length and parenchymal border widththis measurement should be done in longitudinal section. Also the comparison of both parameters between the right and the left kidney should be carried out and if possible a comparison with previous measurements, should be made.
Longitudinal measurement
The maximal longitudinal axes should be evaluated from the ventral side according to the longitudinal axes of the kidney (Figure 1a and 1b). It is imperative to make several measurements.
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Parenchymal width
This must be measured at the point of transition between columna renalis and the beginning of the medulla (Figure 2a and 2b). This measurement should not be performed at the upper and lower poles, but in the middle third of the kidney. The section should be perpendicular to the renal surface (avoid sections in an oblique plane).
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There is no upper limit of normal which is applicable to all patients. A rather large parenchymal width should be a hint to exclude a compensatory hypertrophy of the kidney, diabetes mellitus, acute nephritis or acute renal failure, or to look for physiological reasons, e.g. pregnancy.
Common error: comparison of examination of the right kidney from ventral aspect (hepatic window) with left kidney examined from the flank (spleen window or section behind the colon).
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