What are the normal sizes of the kidneys according to ultrasound in adults, and will the diagnosis show hydronephrosis, stones and other formations? Ultrasound of the kidneys - interpretation of the norm: position, size.

The size of the kidneys on ultrasound can be conveniently examined from the back. To bring out the upper pole of the kidney, ask the patient to deep breath. If you are obese, look for an acoustic window in the intercostal spaces along the anterior and posterior axillary lines. Newborns and young children can be scanned through the anterior abdominal wall.

Click on the picture to enlarge.

On a longitudinal section, the length (green) of the kidney is measured, as well as the thickness of the parenchyma (blue) - the distance from the capsule to the top of the pyramid, the thickness of the cortex (blue) - the distance from the capsule to the base of the pyramid. On the cross section, the height (pink) of the bud and the width (yellow) of the bud are measured.

Kidney size on ultrasound in adults

In an adult, the normal length of the kidney is 90-120 mm. If the patient is non-standard (very small or large), then the length of the kidney is calculated using the formula: 35 + 0.42 * height (cm). Often left kidney longer than the right one. If the difference does not exceed 1 cm with a normal echostructure, it does not matter.

The width and height of the kidney should be correctly measured when transverse scanning. In an adult, the normal width of the kidney is 40-70 mm, and the height is 30-50 mm.

Length, width and height are in the ratio 2:1:0.8. When the shape of the kidney changes, this relationship is disrupted.

Some authors believe that kidney length depends little on body length; a more significant relationship is between kidney volume and body weight. Kidney volume (ml) should be twice the body weight (kg) ± 20%. Kidney volume is calculated using the formula: Length*Height*Width* 0.523.

The normal thickness of the kidney parenchyma is 15-25 mm. The normal thickness of the cortical layer is 8-11 mm.

The thickness of the parenchyma can be assessed by the ratio of parenchyma to sinus. On a transverse section at the renal hilum, the sum of the anterior and posterior parenchyma (blue) and the hyperechoic sinus between them (red) are measured. The normal ratio of parenchyma to sinus up to 30 years is >1.6; from 31 to 60 years - 1.2-1.6; over 60 years old - 1.1.

Kidney size on ultrasound in children

The length of the kidney in a full-term newborn is on average 45 mm. By 1 year it increases to 62 mm. Then every year the bud increases in length by 3 mm. A difference in length of up to 5 mm is allowed between the kidneys.

Table. Kidney size in children depending on height (M±σ) according to Pykov -

When lagging or accelerated physical development it is better to use the renal mass index. The specific gravity of the kidney is close to 1, so the volume is equal to the mass. The mass of the kidney is calculated using the formula: Length*Height*Width* 0.523. The ratio of total renal mass to body weight (in grams) is 0.04-0.06%.

Drawing. Healthy boy, age 7 years. Weight 40 kg, height 138 cm. On ultrasound, the length of the kidneys is 95 and 86 mm. The length of the kidney according to the formula = 62+3*6 = 80 mm, and according to the table, with a height of 138 cm, the upper limit of the norm is 90 mm. Renal mass index = (88.37+84.90)/40000 = 0.043. Thus, for nonstandard children, the renal mass index is preferable. Conclusion: The size of the kidneys corresponds to the weight of the child.

The thickness of the renal cortex in a newborn is 2-4 times less than the thickness of the pyramids. With age, this ratio tends to 1.

Sizes of the pelvis on ultrasound

The ureter, minor and major calyces are normally not visible on ultrasound. There are three types of location of the pelvis: intra-, extrarenal and mixed type. With an intrarenal structure, the lumen of the pelvis is in early age up to 3 mm, at 4-5 years - up to 5 mm, in puberty and in adults - up to 7 mm. For extrarenal and mixed types of structure - 6, 10 and 14 mm, respectively. When the bladder is full, the pelvis can increase to 18 mm, but 30 minutes after urination it contracts.

Drawing. Regardless of the filling of the bladder, ultrasound shows a pelvis of mixed (1) and extrarenal (2) location, as well as under the fibrous bridge (3).

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Ultrasound results in adult women and men

Diagnosis of kidney condition does not differ between people of different genders. The norms of indicators are the same for both men and women. The normal size of a woman's kidneys is different during pregnancy. The norm is considered to be lengthening of the organ up to 2 cm; slight expansion is allowed along with the pelvis and ureters. The norm for adults when decoding the results is as follows: thickness - 40-50 mm, length 100-120 mm, width 50-60 mm, thickness of the functional part - 15-25 mm. The sizes of the right and left kidneys differ, but no more than 2 cm. The normal ultrasound scan of the kidneys in an adult is determined by the height indicator. Using the table below, you can determine the normal size of the kidneys relative to a person's height.

Today, ultrasound examination is often used to diagnose kidney diseases. It allows you to visualize the shape of the organ, its size, structure, contours, the presence of pathological foci, blood flow supplying the tissues. Our article will tell you what the interpretation of kidney ultrasound is, what indicators indicate the presence of diseases.

Decoding

The kidneys are a paired organ. However, it happens that people have one of them removed for some reason. In this case, the entire load has to be carried out by one kidney. During a kidney ultrasound, the doctor pays attention to the following parameters:

number of organs. In addition to the fact that one kidney occurs, the phenomenon of an additional kidney is possible. There is a pathology in the form of double kidneys. In this case, most often the additional organ is undeveloped;
size. Width and length are measured using ultrasound. These parameters vary depending on the patient’s age, height, weight;
location. The norm is the location of the right kidney below the left;
a healthy kidney has a bean-shaped shape with a uniform structure and an even contour;
Normal kidney thickness should be in the range of 14–26 mm. Moreover, the older a person is, the thinner his kidneys are. In older people, the thickness varies from 10 to 11 mm. If this parameter is increased, then this indicates an inflammatory process or swelling; a reduced organ indicates dystrophy;
echogenicity should be homogeneous. With hypoechogenicity, the tissue structure stands out dark spot, with hyperechogenicity - light. In addition, there is a homogeneous and heterogeneous structure. The latter is characterized by alternating increased echogenicity with normal tissue;
Doppler ultrasound will assess blood flow. During the study, a color image is displayed on the monitor. Dark colors they talk about normal blood flow, which varies from 50 to 150 cm per second. Bright colors signal increased blood flow.

Men's and women's sizes

Many people are interested in the question of whether there is a difference in the size of the kidneys in women and men. Normal organ parameters do not change in people of different sexes. However, it is considered normal change parameters in a pregnant woman. The norm can lengthen by 2 cm, and expansion of the pelvis and ureters is also acceptable.

Usually, according to ultrasound in adults, the following kidneys are considered normal:

with a thickness from 40 to 50 mm;
length from 100 to 120 mm;
width from 50 to 60 mm;
functional area thickness from 15 to 25 mm.

The right and left kidneys should not differ from each other by more than 20 mm. Below is the table normal indicators according to the patient's height.

Children's sizes

Kidney ultrasound is often performed to diagnose children. It allows you to determine the presence congenital anomalies. Most often, the procedure is prescribed if there are complaints of pain in the lower back, lower abdomen, after injuries, or problems with urination. A newborn examination is carried out to exclude anomalies that are associated with heredity, in case of a difficult pregnancy, in serious condition baby at the time of birth.

Common pathologies

More often ultrasound diagnostics detects the following kidney pathologies:

If there is excessive mobility or a displaced state, a diagnosis of nephroptosis is made, which causes impaired renal circulation and increases kidney pressure. The most common diagnosis is prolapse of the right kidney. The left organ descends much less frequently. The rarest phenomenon is nephroptosis of both kidneys. If the kidney has dropped by 1.5 vertebrae, then this is a sign of 1st degree of the disease, by 2 vertebrae - 2nd degree, by 3 vertebrae or more - 3rd degree;
when visualizing neoplasms in the form of sand and small stones, a diagnosis of microcalculosis is made;
detection of neoplasms such as cysts and abscesses is determined by low echogenicity of a rounded shape;
traumatic lesions, which can be either open or closed;
uneven contours, limited mobility, enlarged kidneys are manifested in patients with pyelonephritis;
uneven contours, increased echogenicity, decreased blood flow indicate the presence of renal failure;
reduced thickness of the parenchyma, lack of visualization of the hydronephrotic sac indicates the presence of hydronephrosis;
a thick capsule of heterogeneous substance with increased blood flow indicates an abscess.

Changes indicating pathologies

The doctor, based on the average results, makes an assumption about the presence of pathologies based on the following changes:

a decrease in size indicates glomerulonephritis;
increase – hydronephrosis, tumor processes, blood stagnation;
a shift in the location of the kidney indicates nephroptosis;
complete change in localization - dystopia;
enlarged parenchyma - inflammatory process;
reduced parenchyma – renal dystrophy;
poorly visible boundaries – hydronephrosis;
compacted tissues visible in a light shade are a sign of glomerulonephritis, pyelonephritis;
darkened tissues indicate cysts;
compaction of the pelvis is a sign of a benign or malignant tumor;
an enlarged renal calyx indicates ICD.

Preparation

To obtain the most reliable information, you need to pay attention to preparatory activities. Before the procedure, it is important not to eat for 6 hours. For 3 days you should avoid eating foods that cause increased gas formation. It is also not recommended to smoke, suck candy, or chew gum immediately before an ultrasound.

In addition, in order to properly prepare, you should drink at least 1 liter an hour before the procedure. clean water. Filling the bladder will help improve the ultrasound and improve the quality of the examination. During pregnancy, women can have their kidneys diagnosed by ultrasound, this procedure does not have a detrimental effect on the fragile body of the fetus.

For information, if the transcript indicates increased pneumatosis, then this is considered a sign increased gas formation. This circumstance is evidence that the preparation for the procedure was poorly carried out. Ultrasound is quite informative method diagnosing the condition of the renal apparatus. It allows you to identify many diseases at their initial stage of manifestation.

In most cases, ultrasound examination can be called fully informative and sufficient method diagnostics in order to determine kidney disease and prescribe adequate treatment, including excluding pathologies during screening examinations. The price of a kidney ultrasound is quite reasonable; it must be clarified at the reception desk of the medical institution.

An ultrasound examination device allows the doctor to determine several important parameters during examination: the state of blood flow, the size of the organ, signs of inflammatory processes, the state of the parenchyma structure, the presence of stones in the cavities, as well as malignant or benign neoplasms.

What indicators are being studied?

Number of kidneys.
Organ dimensions.
Its localization.
Shape and contours.
Structure of the renal parenchyma.
State of blood flow.

Let's consider these parameters in more detail.

Quantity

In this article we will understand how to decipher an ultrasound of the kidneys.

The norm for a person is to have a pair of kidneys, but anomalies can also be found. May be congenital absence one of them is the so-called agenesis (unilateral aplasia). Or the kidney could be removed through surgical intervention. You can also find congenital organ duplication, most often it is unilateral.

Location

The normal location of the kidneys can be called their location on at different levels each other relative to each other. The right one, D, is located at the level of the 2nd lumbar vertebra and the 12th thoracic, and the left, L, is located at the level of the 1st lumbar vertebra and the 11th thoracic.

An ultrasound examination of a woman’s kidney helps to identify nephroptosis (prolapse) or dystopia, that is, its atypical location in the pelvis. The normal shape of the kidney is bean-shaped with an even contour and clear viewing fibrous capsule, which is the outer shell of the organ. Normal sizes for pregnant women are different, since during this period the kidney lengthens by two centimeters. A slight expansion of the pelvis and ureter is also permissible.

Adult sizes

The physiological norm for the size of the kidneys in an adult is 40-50 mm in thickness, 50-60 mm in width, 100-120 mm in length. However, these indicators may vary slightly depending on the gender and height of the patient.

The thickness of the parenchyma layer is another important parameter when interpreting kidney ultrasound. The norm is 18-25 mm. Nevertheless this indicator depends on the age of the person. For older people, it is possible to reduce it to 11 mm, which is associated with sclerotic changes. Parenchyma is the tissue in which nephrons, structural and functional units, are located. If its thickness increases, this may indicate inflammation or swelling of the organ, and if it decreases, then we can talk about its dystrophy.

Children's sizes

An ultrasound scan of a newborn baby is necessary if high probability abnormal development he has internal organs due to heredity, difficult pregnancy and childbirth, changes in the baby’s urine. Ultrasound of the kidneys for older children is prescribed after detecting abnormalities in tests, with complaints of pain in the lower back or lower abdomen, due to injury, or with urination problems.

In children, the size of the kidneys depends on height and age. If the height is less than 80 cm, then only 2 parameters are measured: the width and length of the organ. In a child over 100 cm, the thickness of the parenchyma is also measured.

Kidneys increase in size when acute glomerulonephritis or pyelonephritis, as well as in case of loss of pairing, since in this case the organ will experience increased functional load.

When decoding an ultrasound of the kidneys, the norm is to clearly identify the boundaries of the pyramids of the parenchymal layer. Their echogenicity should be lower than that of the parenchyma. If such a difference is not detected during examination, this may indicate hydronephrosis.

Parenchyma echogenicity

This indicator determines the condition and structure of the kidney tissue, which is normally homogeneous.

Echogenicity is the degree of intensity of reflection from tissues sound wave. The reflection is more intense and the image on the monitor is lighter when the parenchyma is denser. In low-density tissues, echogenicity is weak, with visualization in the form of dark areas.

Air and liquids are anechoic. For example, a cavitary cyst containing fluid is described by a specialist as an anechoic formation. Sclerotic processes, on the contrary, are characterized by hyperechogenicity.

The collecting system or cavitary system is responsible for performing the function of collecting urine. Using kidney ultrasound, men are diagnosed the following types changes in it: the presence of calculi (sand, stones), pyelonephritis (inflammatory compaction of the mucous membrane of the pelvis). Also expansion of the ChLS may indicate calicoectasia, pyelectasia, tumors, ureteral obstruction and hydronephrosis.

The norm for the pyelocaliceal system is its anechoicity. Stones whose size is 4-5 mm or more are described by ultrasound as an echogenic formation, hyperechoic inclusion, or echogenicity. The presence of sand in the organ is called microcalculosis.

Renal blood flow

To visualize blood vessels organ, use duplex scanning, in which the ultrasound scanner produces information in a spectral graph or color image. This technique is painless and non-invasive. Therefore, it can be used when examining kidneys in children. Ultrasound determines the condition of the walls of blood vessels, the presence of stenoses and intravascular obstructions, as well as the speed of blood flow. Its normal variation is from 50 to 150 cm/sec.

For a color scheme, dark tones are considered normal, and bright colors indicate accelerated blood flow, indicating the presence of stenosis, the main symptom of which is an increase in speed in renal artery(200 cm/sec). The blood flow resistance index is also determined, which depends directly on the person’s age. The older the patient, the higher it is. For the renal artery, the normal value of the resistance index is 0.7, and for the interlobar arteries it is 0.34-0.74.

Detection of pathological damage

Ultrasound is also used to confirm kidney injury. There are 5 categories of injuries to this organ. They differ in the degree of violation:

the organ is minimally damaged, there are no ruptures (detection of a subcapsular hematoma of the kidney);
the cortex is torn;
the cortex is torn by more than a centimeter, while extravasation of contrast is not observed;
the ureteropelvic segment is disrupted;
the vascular pedicle is damaged or it is torn off from the vessels and ureter.

Decoding the results

Interpretation of kidney ultrasound, the norms of which are given above, should be carried out by a urologist. The conclusion is usually accompanied by a sonogram or an attached ultrasound photo, on which arrows mark the place where the pathological changes. If upon detection vascular changes or tumors, an ultrasound video will be attached, this will help make the correct diagnosis.

Abnormalities detected by ultrasound

The most informative is ultrasound diagnostics when detecting diseases such as damage to the renal vessels, nephroptosis, amyloidosis, narrowing of the ureters, organ dystrophy, abscesses, cysts, tumors, hydronephrosis, stone formation, inflammatory processes (glomerulonephritis, pyelonephritis).

When the ultrasound report indicates “severe intestinal pneumatosis,” this means that the examination was uninformative due to flatulence. In this case, the ultrasound will need to be repeated, having previously prepared, that is, by drinking carminative drugs.

Kidney ultrasound: price

The cost of this study depends entirely on the chosen clinic and region. If an ultrasound is performed on the direction of a doctor, it can be free. In private specialized center in Moscow average price ranges from 500 rubles to 3500. In the regions, the cost will be slightly lower, but not significantly. You can pay for research from 350 rubles to 2500.

From this article you learned about ultrasound, the norms of its indicators, as well as kidney disorders that can be detected during the examination.

Human kidney anatomy
Standard Kidney Growth Indicators
Factors that influence sizes

- This is a special paired organ, the functions of which cannot be taken over by other systems. They cleanse the body of harmful substances, driving blood through itself. What size should the kidneys be? The size of the kidneys is one of the main indicators when establishing a diagnosis for various kidney diseases. Normal sizes may vary depending on the age and gender criteria and the person’s weight.

Human kidney anatomy

Topographic anatomy of the kidneys is the following features. This component excretory system, being a paired organ, is projected differently to other organs. The right component of the system is adjacent to the adrenal gland and liver. The left component is in contact with the adrenal gland, stomach and spleen. At the back, both organs are adjacent to the diaphragm.

Each of these elements of the excretory system is covered on top special capsule of connective fibers and a serous accessory membrane. The renal parenchyma is formed from the medulla and cortex. The first is approximately 15 pyramids of a conical type with rays at their base. These rays grow into the continuous cortical shell.

Each kidney contains up to 1 million nephrons. They are the main constituent units of these components of the human excretory system. They are formed from tubules, corpuscles and passing blood vessels.

The pelvis is a special cavity that receives urine. The ureter receives urine from the pelvis and then sends it to the bladder.

The renal artery is a blood vessel that arises from the aorta. He brings polluted blood. The renal vein is a blood vessel that carries pure blood to the main vein.

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Standard Kidney Growth Indicators

The longitudinal size of the organ should be approximately from 80 to 130 mm. In an adult, the length of this internal organ should correspond to the height of three vertebrae lumbar region. The width for men can be up to 70 mm, and the thickness up to 50 mm. For any size, the ratio of length to width should correspond to a clear ratio of 2:1. Since all parameters of height and weight of the stronger sex are often greater than those of women, the size of this component of the excretory system is smaller in the weaker sex.

If we compare the dimensions of human parenchyma with standards, then the thickness should be no less than 15 mm and no more than 25 mm. With increasing age and the development of inflammatory and atherosclerotic processes, the parenchyma may become thinner. In most cases, after 60 years of age, the patient's parenchyma decreases to a size of 11 mm.

To find out all the dimensions of this component of the excretory system, ultrasound is used. If we summarize the information about the structure and size, then with relatively good health the kidneys are approximately the size of a fist.

IN childhood Some difficulties arise with the determination of standardization and normalization of renal parameters due to the fact that children grow and develop individually. To determine the norm, you need to know the weight and height of the child. Approximate values are as follows:

in infants it will be 50 mm;
at 2-3 months it reaches 63 mm;
at 5 years – 75 mm;
at 10 years – 85 mm;
at 15 years old the value is 98 mm;
20 years – 105 mm.

An interesting phenomenon is that an infant has a size to weight ratio that is 3 times greater than an adult.

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Factors that influence sizes

In general, the size of the kidneys is affected by a person’s gender, age and weight. Scientists have found that a person's mass index affects overall size, volume, height and height.

It was found that the right organ is smaller than the left, which is due to the fact that the liver prevents its growth.

The size of the organ can increase up to 25 years, after which it stops growing, but after 50-60 years it begins to decrease in size.

In diabetes mellitus or hypertension, renal hypertrophy may occur.

It is very important to monitor the size and functioning of the renal structures, because this paired organ has great value For normal functioning total human body.

Ultrasound diagnostics of pathology of the urinary system received positive feedback from both medical workers, and in patients. Ultrasound diagnostics of nephropathology in women during pregnancy is of particular importance. She has won a worthy place among diagnostic procedures, thanks to its safety, simplicity and effectiveness. For example, the main method for diagnosing hydronephrosis is ultrasound. Quite often prescribed in conjunction with ultrasound of the bladder and its ducts.

For greater information, kidney ultrasound is often prescribed in conjunction with an examination of the bladder and its ducts. This gives the doctor the opportunity to see the full picture of the pathology urinary system

Indications for ultrasound of the urinary system

Any examination, even one as safe and non-traumatic as an ultrasound examination, must be carried out according to indications. For ultrasound examination, the reasons for conducting diagnostics are:

observation for chronic diseases of the urinary system (pyelonephritis, glamerulonephritis, cysts, etc.);
preventive examination;
regular headaches of a migraine nature, as well as against the background of hypertension;
swelling lower limbs, faces;
endocrine diseases;
congenital pathologies of the genital organs;
injuries and pain in the lumbar region;
disturbance of urination (frequency, incontinence, pain during the process), suspicion of hydronephrosis;
renal colic;
changes in OAM data (protein, blood, mucus in urine).

Ultrasound is also prescribed when the patient experiences the first symptoms of foreign bodies in the kidneys to identify their parameters and structure. An examination is carried out if there is a violation of the outflow of urine to identify inflammation and determine the size renal pelvis, if you suspect the development malignant neoplasms, with severe edema in pregnant women, as well as to determine the location of the kidneys and their size during a medical examination.

Pathologies detected by ultrasound diagnostics

What does a kidney ultrasound show? The ultrasound diagnostic procedure can detect a number of changes in the urinary system from simple to very serious:

inflammatory diseases of the urinary system (for example, nephritis);
traumatic diseases;
congenital anomalies;
neoplasms;
diseases vascular system kidneys (it is possible to perform an ultrasound scan of the kidney vessels);
damage to parenchymal tissues;
injuries;
hydronephrosis.

Parameters assessed during ultrasound examination

During ultrasound diagnostics, the number of organs (one, two, the presence of an additional organ), mobility, location and shape, parameters and structure are assessed, the renal pelvis and ureters are studied. At in good condition In the body, the mobility of organs is not great and amounts to up to one and a half centimeters. In case of prolapse or the so-called “wandering” kidney, mobility increases.

Normal position of the kidneys- on both sides spinal column(left is higher than right). However, they can change their location and be on one side (one under the other), in the pelvic area (this prolapse of the kidneys is called nephroptosis).

Normal form for this organ - bean grain. In case of developmental anomalies, the organs can take the shape of a horseshoe, the English letters “S” and “L”, and sometimes their fusion is observed.

The normal shape of the kidneys resembles the outline of beans. However, with the development of pathologies, they can take the form of a horseshoe or the English letter “S”

One of the most important diagnostic indicators is the size of the kidneys. These parameters are different for children and adults. For children, there is a separate table with the norms of indicators and their interpretation. But no matter what the specifics of interpreting the results of kidney ultrasound in children or pregnant women may be, most diseases of the urinary system are accompanied by changes in the size of the kidneys (for example, hydronephrosis leads to an enlargement of this organ).

Normal size indicators kidneys in an adult are as follows:

the thickness of the renal parenchyma is about 23 mm;
length is 100-120 mm;
the organ has a width of 40-50 mm;
the thickness of the organ is about 45-55 mm, the thickness of the renal capsule is about 1.5 cm;
one organ weighs 120-200 grams.

An increase in these parameters indicates inflammatory processes: we can talk about pyelonephritis, hydronephrosis. A decrease occurs with hypoplasia and some other diseases and developmental anomalies.

There is also a decrease in kidney parenchyma with age, after surgical interventions associated with kidney removal. The remaining organ, taking over the functions of its distant counterpart, may undergo changes in the direction of increase.

Structure healthy kidney not homogeneous, the contours are visualized as smooth and clear. The development of any disease affects this structure. Compaction of some structures indicates inflammation, the presence of foreign formations (conglomerates, stones) indicates the accumulation of sand and stones or the development of a tumor. Echo signs of hydronephrosis are: enlargement of the affected organ and accumulation of fluid in its cavities.

Calyces and renal pelvis normally should not be visualized. They are anechoic in nature and are determined by ultrasound diagnostics only when they develop pathological process. For example, dilation of the pelvis indicates the development of pyelonephritis, hydronephrosis and calculosis.

Ureters Normally they have a length of 25-30 cm, and normally on ultrasound they have light walls with a dark cavity. In the case of pathological bends, shortening/lengthening of the ureters, the outflow of urine is disrupted and development infectious processes. Duplication of the ureters may also occur, and the place where the ureter opens into the kidney may be blocked by a valve. In addition, there may be a stone in the ureter. All these changes will be revealed by ultrasound.

Ultrasound examination makes it possible to determine the presence of stones in the ureters so that the doctor can take timely measures to neutralize them

Interpretation of ultrasound data and doctor’s report

Interpreting kidney ultrasound is the job of a qualified specialist. However, anyone can become familiar with the basic concepts that may appear in the ultrasound diagnostic doctor’s conclusion. The following results are often encountered:

Volumetric echo-positive formations are neoplasms. In case of homogeneity we're talking about O benign education. In case of heterogeneity and uneven contour of the formation, we are talking about a malignant tumor.
Cysts are located as non-echoic (anechoic) volumetric formations. Their parameters and contents are indicated in the conclusion.
Microliths are sand or small stones up to 3mm.
Conglomerate (echo-shadow, hyper-echo-like formation) – stones.
The presence of hypoechoic zones in the renal parenchyma indicates edema ( common symptom pyelonephritis).
The presence of hyperechoic zones in the renal parenchyma is evidence of hemorrhage.
A spongy structure may indicate congenital cystosis.
An enlarged pelvis indicates hydronephrosis and ureteral obstruction.
Consolidation of the mucous membrane of the renal pelvis indicates swelling of the tissue, this is another evidence of pyelonephritis.

Kidneys are unique organs. During the day, they manage to pass all the blood through themselves hundreds of times and thereby cleanse it of harmful substances, and their health can be assessed by measuring their basic parameters during an ultrasound. Therefore, based on whether the size of the kidney is normal, one can judge its performance.

Every healthy person has 2 kidneys, which are located inside abdominal cavity in the lumbar region. Each of them is bean-shaped and weighs about 150–200 g. However, usually the left kidney is slightly larger than the right, which is explained by the presence in the right half of the body of a fairly large liver, which somewhat impedes vertical growth right bean-shaped organ.

In some cases, even at the stage of intrauterine development, disruptions in the formation of internal organs occur, so sometimes people are born with 1 kidney or, conversely, with double the number of them. But, as a rule, this in no way affects the quality of functioning of the whole organism and its congenital defects development, patients learn when undergoing ultrasound examinations for completely different reasons.

Each kidney consists of certain structural elements, the size, clarity of boundaries and shape of which are important diagnostic value. This:

The connective tissue capsule and serous membrane that cover each of these paired organs.
Parenchyma. It is formed by the cortex and medulla. In addition, the parenchyma contains epithelial tubules and special renal corpuscles, which together with numerous blood vessels form nephrons.
Near the nephrons is a funnel-shaped cavity called the pelvis.
The pelvis smoothly passes into the ureter, through which urine already formed in the nephrons is excreted into the bladder, and then into the external environment.

Important: each kidney has about 1 million nephrons, which are their structural units.

Kidney structure

In addition, an important parameter in assessing the quality of work of these organs is the patient’s age, since the size of an adult’s kidney remains relatively stable between 25 and 50 years. Therefore, if until the age of 20 or even 25 these organs continue to increase, then after the 50th anniversary there is usually a decrease in their size.

Also, the size of the kidneys is directly proportional to a person’s body mass index. Therefore, as BMI increases, the size of each of the body’s main filters also increases.

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But the most important evaluation parameter is not so much the size of each of the kidneys, but their ratio. Normally, the difference between the size of the right and left kidney should not exceed 1.5 cm.

In a healthy adult, the kidney has the following parameters:

length – 80–130 mm;
width – 45–70 mm;
thickness – 40–50 mm.

Attention! Traditionally, the length of the kidney corresponds to the height of the 3 lumbar vertebrae, but in any case the ratio of length to width is always 2:1.

As for children, then for kids different ages other values are typical. So, the average length of a bud is:

0–2 months – 49 mm;
3–12 months – 62 mm;
1–5 years – 73 mm;
5–10 years – 85 mm;
10–15 years – 98 mm;
15–19 years old – 106 mm.

Important: since all children develop differently, it is difficult to accurately establish normal limits for them, therefore, for the most reliable assessment of the condition of the kidneys, when measuring their size, be sure to take into account the child’s weight, height and body type.

Hypertrophy may indicate development diabetes mellitus, but sometimes it is a variant of the norm

To diagnose a number of pathologies, doctors need to assess the thickness of the parenchyma. In healthy young people, the normal size of the kidney parenchyma ranges from 15 to 25 mm. But since various degenerative processes occur in it over the years under the influence of certain diseases in older people, its thickness, as a rule, does not exceed 11 mm.

Important: in an ordinary healthy person, the size of the kidney is no different from the size of the fist.

Thus, ultrasound can be used to assess the condition of the kidneys. But one cannot delay in carrying out this painless, accessible and highly informative study, since the sooner the pathology is identified, the greater the chance that a person will have that his natural “filters” will be completely restored.

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The human kidney is a unique paired organ that continuously cleanses the blood of substances harmful to the human body. The size of the kidney is normal - this is one of the most important diagnostic parameters. They vary depending on age, gender and body mass index.

Let's look at the main structural elements kidneys:

The kidney is covered with a thin connective tissue capsule and a serous membrane (in front).
The kidney parenchyma consists of the cortex and medulla. The cortex is located in a continuous layer under the renal capsule. The medulla is 10-18 conical pyramids with medullary rays located at the base, growing into the cortex. The renal parenchyma is represented by epithelial tubules and renal corpuscles, which together with blood vessels form nephrons (up to 1 million in each kidney).
The structural unit of the kidney is the nephron.
The funnel-shaped cavity that receives urine from the nephron is called the pelvis.
The organ that receives urine from the renal pelvis and transports it to the bladder is called the ureter
The blood vessel that branches from the aorta and brings blood contaminated with waste products to the kidneys is called the renal artery, and the vessel that delivers filtered blood to the vena cava is called the renal vein.

What factors influence kidney size?

Numerous studies have found that the thickness, width and length of the cortical layer, as well as the size of the kidney in men are much larger than in women. This is due to the fact that representatives of the stronger sex have body sizes that exceed those of the female body.

At the same time, the researchers found an insignificant difference between the lengths of the right and left kidneys (the left kidney is on average 5% larger than the right). According to experts, the vertical growth of the right kidney is hampered by the liver.

Also, the size of an adult’s kidney is greatly influenced by age. The kidneys “grow” until the age of twenty to twenty-five, then they remain relatively stable throughout middle age, and after fifty years they begin to decline.

During the research, it was found that kidney size is closely related to body mass index (BMI). As BMI increases, not only the size of the kidneys increases, but also their volume, height and height.

Note: with the development of hypertension or diabetes mellitus, renal hypertrophy develops.

The longitudinal size of the adult kidney is on average 100-120 mm (more precisely, from 80 to 130 mm). As a rule, the length of the kidney corresponds to the height of three lumbar vertebrae, the width is in the range of 45-70 mm, and the thickness is 40-50 mm.

Note: no matter what size the bud is, the ratio of its length to width is 2:1.

In young people, the normal size of the kidney parenchyma (its thickness) ranges from 15-25 mm. With age, as a result of atherosclerotic processes or inflammation, its thinning occurs, and in people over sixty years of age, the thickness of the parenchyma often does not exceed 11 mm. To assess the structure of the kidney in clinical practice The parenchymopyelic index is used.

I would like to note that the size of a healthy person’s kidney does not exceed the size of his fist.

Kidney structure

Kidney size in children

It should be noted that all children develop differently, and therefore difficulties arise in determining the size of the kidneys in childhood. However, during research, scientists were able to determine average length kidneys based on age:

From birth to two months, the kidney size is 49 mm;
From three months to one year – 62 mm;
From one to five years – 73 mm;
From five to ten years – 85 mm;
From ten to fifteen years - 98 mm;
From fifteen to nineteen years - 106 mm.

With more precise definition The size of a child’s kidney takes into account his weight and height.

Interesting fact: Babies have kidneys, relative to body weight, that are three times larger than adults.

The main function of the kidneys is to cleanse the blood of waste and toxic substances. The most harmful waste products of the human body are urea and uric acid. Cluster large quantity These substances cause the development of numerous severe pathologies, and this can also lead to death. During the filtration process, the renal parenchyma cleanses the body of waste (they are collected in the pelvis and transported to the bladder).

An interesting fact: the kidney parenchyma manages to completely cleanse the blood about fifty times per day.

The main functions of the kidneys include:

Urine formation. Thanks to the kidneys, excess water, organic and inorganic substances, as well as nitrogen metabolism products and toxins;
Maintaining normal water-salt balance(due to fluid excreted in urine);
Regulation blood pressure(due to the secretion of renin, excretion of water and sodium, as well as depressor substances);
Regulation of pH levels;
Hormone production;
Vitamin D production;
Regulation of hemostasis (formation of humoral regulators of blood coagulation, as well as participation in heparin metabolism);
Regulation of erythropoiesis;
Metabolic function (participation in the metabolism of proteins, carbohydrates and lipids);
Protective function (removal of foreign and toxic substances from the body).

Note: with the development of various pathological conditions renal excretion is often impaired medicines, and therefore patients may experience side effects and even poisoning.

In most cases, ultrasound can be called a fully informative and sufficient diagnostic method to determine kidney disease and prescribe adequate treatment, including excluding pathologies during screening examinations. The price of a kidney ultrasound is quite reasonable; it must be clarified at the reception desk of the medical institution.

Let's consider these parameters in more detail.

In this article we will understand how to decipher an ultrasound of the kidneys.

The norm for a person is to have a pair of kidneys, but anomalies can also be found. There may be a congenital absence of one of them, so-called agenesis (unilateral aplasia). Or the kidney could be removed through surgery. You can also find congenital organ duplication, most often it is unilateral.

The normal location of the kidneys is that they are at different levels relative to each other. The right one, D, is located at the level of the 2nd lumbar vertebra and the 12th thoracic vertebra, and the left one, L, is located at the level of the 1st lumbar vertebra and the 11th thoracic vertebra.

An ultrasound examination of a woman’s kidney helps to identify nephroptosis (prolapse) or dystopia, that is, its atypical location in the pelvis. The normal shape of the kidney is bean-shaped with a smooth contour and a clear view of the fibrous capsule, which is the outer shell of the organ. Normal sizes for pregnant women are different, since during this period the kidney lengthens by two centimeters. A slight expansion of the pelvis and ureter is also permissible.

The thickness of the parenchyma layer is another important parameter when interpreting kidney ultrasound. The norm is 18-25 mm. However, this indicator depends on the age of the person. For older people, it is possible to reduce it to 11 mm, which is associated with sclerotic changes. Parenchyma is the tissue in which nephrons, structural and functional units, are located. If its thickness increases, this may indicate inflammation or swelling of the organ, and if it decreases, then we can talk about its dystrophy.

An ultrasound scan of a newborn baby is necessary if there is a high probability of abnormal development of its internal organs due to heredity, difficult pregnancy and childbirth, or changes in the baby’s urine. Ultrasound of the kidneys for older children is prescribed after detecting abnormalities in tests, with complaints of pain in the lower back or lower abdomen, due to injury, or with urination problems.

The kidneys increase in size with acute glomerulonephritis or pyelonephritis, as well as with loss of pairing, since in this case the organ will experience increased functional load.

This indicator determines the condition and structure of the kidney tissue, which is normally homogeneous.

Echogenicity is the degree of intensity of reflection of a sound wave from tissue. The reflection is more intense and the image on the monitor is lighter when the parenchyma is denser. In low-density tissues, echogenicity is weak, with visualization in the form of dark areas.

The collecting system or cavitary system is responsible for performing the function of collecting urine. Using an ultrasound of the kidneys in men, the following types of changes in it are diagnosed: the presence of stones (sand, stones), pyelonephritis (inflammatory compaction of the mucous membrane of the pelvis). Also, enlargement of the maxillary tract may indicate calicoectasia, pyelectasia, tumors, ureteral obstruction and hydronephrosis.

To visualize the blood vessels of an organ, duplex scanning is used, in which the ultrasound scanner produces information in a spectral graph or color image. This technique is painless and non-invasive. Therefore, it can be used when examining kidneys in children. Ultrasound determines the condition of the walls of blood vessels, the presence of stenoses and intravascular obstructions, as well as the speed of blood flow. Its normal variation is from 50 to 150 cm/sec.

For the color scheme, dark tones are considered normal, and bright colors indicate accelerated blood flow, indicating the presence of stenosis, the main symptom of which is an increase in velocity in the renal artery (200 cm/sec). The blood flow resistance index is also determined, which depends directly on the person’s age. The older the patient, the higher it is. For the renal artery, the normal value of the resistance index is 0.7, and for the interlobar arteries it is 0.34-0.74.

Ultrasound is also used to confirm kidney injury. There are 5 categories of injuries to this organ. They differ in the degree of violation:

the organ is minimally damaged, there are no ruptures (detection of a subcapsular hematoma of the kidney);
the cortex is torn;
the cortex is torn by more than a centimeter, while extravasation of contrast is not observed;
the ureteropelvic segment is disrupted;
the vascular pedicle is damaged or it is torn off from the vessels and ureter.

Interpretation of kidney ultrasound, the norms of which are given above, should be carried out by a urologist. The conclusion is usually accompanied by a sonogram or an attached ultrasound photo, on which arrows mark the place where pathological changes are detected. If vascular changes or tumors are detected, if an ultrasound video is attached, this will help make the correct diagnosis.

The cost of this study depends entirely on the chosen clinic and region. If an ultrasound is performed on the direction of a doctor, it can be free. In a private specialized center in Moscow, the average price ranges from 500 rubles to 3500. In the regions, the cost will be slightly lower, but not significantly. You can pay for research from 350 rubles to 2500.

From this article you learned about ultrasound, the norms of its indicators, as well as kidney disorders that can be detected during the examination.

At the moment, one of the frequently prescribed diagnostic methods that determine the condition of the kidneys is ultrasound examination. The results of a kidney ultrasound will help identify possible organ diseases or pathological manifestations. Using ultrasound, the following parameters are determined: quantity, location, contours, shape and size, structure of parenchymal tissue. It is determined whether there are neoplasms, stones, inflammation and swelling. Renal blood flow is visualized.

Indications for an ultrasound are: impaired urination, the appearance of blood in the urine, pain in the lumbar region, injuries, existing inflammatory processes, poor urinalysis.

Kidney ultrasound allows you to examine the health or progress of the organ’s disease, selecting appropriate therapy based on the data obtained.

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Height	Length, mm		Width, mm		Parenchyma thickness, mm
Height	Left	Right	Left	Right	Left	Right
150	85	82	33	29	13	13
160	92	90	35	33	14	13
180	105	100	38	37	17	15
200	110	105	43	41	18	17

What are the normal sizes of the kidneys according to ultrasound in adults, and will the diagnosis show hydronephrosis, stones and other formations? Ultrasound of the kidneys - interpretation of the norm: position, size.

Kidney size on ultrasound in adults

Kidney size on ultrasound in children

Sizes of the pelvis on ultrasound

Ultrasound results in adult women and men

Decoding

Men's and women's sizes

Children's sizes

Common pathologies

Changes indicating pathologies

Preparation

What indicators are being studied?

Quantity

Location

Adult sizes

Children's sizes

Parenchyma echogenicity

Renal blood flow

Detection of pathological damage

Decoding the results

Abnormalities detected by ultrasound

Kidney ultrasound: price

Human kidney anatomy

Standard Kidney Growth Indicators

Factors that influence sizes

Indications for ultrasound of the urinary system

Pathologies detected by ultrasound diagnostics

Parameters assessed during ultrasound examination

Interpretation of ultrasound data and doctor’s report

What factors influence kidney size?

Kidney size in children

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