Archivos espanoles de urologia · 2026
Ultrasound-Based Prediction of Skin-to-Renal Pelvis Distance for Percutaneous Renal Access.
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Kolvatzis Merkourios, Papaefstathiou Efstathios, Symeonidis Evangelos N, Karkos Christos D, Tsoulfas Georgios, Hatzimouratidis Konstantinos, Moysidis Kyriakos
Аннотация
BACKGROUND: Studies examining anatomical changes in the prone position during endourological procedures lack predictive formulas for estimating the renal pelvis-to-skin distance (KSD). Furthermore, existing equations for renal depth-an important parameter for accurate glomerular filtration rate (GFR) assessment-are based on supine measurements. This study aimed to develop predictive formulas for estimating renal depth in the prone position for patients undergoing percutaneous renal access.
METHODS: A total of 86 healthy volunteers (46 men, 40 women) were enrolled in a prospective study conducted at the 2nd Department of Urology, Papageorgiou General Hospital between June and September 2020. Participants completed a questionnaire on medical history, demographic, and somatometric characteristics. Renal KSD was measured ultrasonographically in the prone position using a convex probe placed parallel and 1 cm below the 12th rib, with the posterior axillary line as a landmark. The biopsy line targeted the midpoint of the renal pelvis. Distances were analyzed in relation to clinical and anthropometric variables, and predictive equations were generated for each kidney.
RESULTS: The following equations were derived: left kidney: distance = 1.5 + 0.272 × body mass index (BMI) - 0.452 × gender; right kidney: distance = 1.619 + 0.259 × BMI - 0.457 × gender (BMI: gender coded as 0 = male, 1 = female). Mean renal depth was 7.81 cm for the right kidney and 8.23 ± 1.47 cm for the left. Distances were significantly greater in men (p = 0.004 right; p = 0.005 left). A strong positive correlation was observed between right and left kidney depths (r = 0.859, p < 0.001), as well as with body weight and waist circumference. In men, greater right kidney depth was associated with hypertension, low high-density lipoprotein (HDL), and metabolic syndrome (p < 0.05).
CONCLUSIONS: These formulas provide a simple and reliable method for estimating renal depth in the prone position, potentially improving procedural accuracy and patient safety during percutaneous renal access.
METHODS: A total of 86 healthy volunteers (46 men, 40 women) were enrolled in a prospective study conducted at the 2nd Department of Urology, Papageorgiou General Hospital between June and September 2020. Participants completed a questionnaire on medical history, demographic, and somatometric characteristics. Renal KSD was measured ultrasonographically in the prone position using a convex probe placed parallel and 1 cm below the 12th rib, with the posterior axillary line as a landmark. The biopsy line targeted the midpoint of the renal pelvis. Distances were analyzed in relation to clinical and anthropometric variables, and predictive equations were generated for each kidney.
RESULTS: The following equations were derived: left kidney: distance = 1.5 + 0.272 × body mass index (BMI) - 0.452 × gender; right kidney: distance = 1.619 + 0.259 × BMI - 0.457 × gender (BMI: gender coded as 0 = male, 1 = female). Mean renal depth was 7.81 cm for the right kidney and 8.23 ± 1.47 cm for the left. Distances were significantly greater in men (p = 0.004 right; p = 0.005 left). A strong positive correlation was observed between right and left kidney depths (r = 0.859, p < 0.001), as well as with body weight and waist circumference. In men, greater right kidney depth was associated with hypertension, low high-density lipoprotein (HDL), and metabolic syndrome (p < 0.05).
CONCLUSIONS: These formulas provide a simple and reliable method for estimating renal depth in the prone position, potentially improving procedural accuracy and patient safety during percutaneous renal access.