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Segmental hypoplasia or Ask-Upmark kidney is a rare renal disease where a part of the kidney has undergone hypoplasia. The number of renal lobes is reduced, and the kidney size is less than two standard deviations from the average, with the weight often being over 50g in adults and 12–25g in children.
The length of the adult kidney is normally 10–12 cm, and the right kidney is often slightly longer than the left kidney. The adult kidney size is variable due to the correlation with body height and age; however, normograms for pediatric kidney size are available. [1]
Each kidney, with its adrenal gland is surrounded by two layers of fat: the perirenal fat present between renal fascia and renal capsule and pararenal fat superior to the renal fascia. The human kidney is a bean-shaped structure with a convex and a concave border. [14]
In addition children under the age of 5 generally have a poorer prognosis than prepubescents, as do adults older than 30 years of age as they have a greater risk of kidney failure. [ 61 ] Other causes such as focal segmental glomerulosclerosis frequently lead to end stage kidney disease .
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The echogenicity of the kidney should be related to the echogenicity of the liver or the spleen. Moreover, decreased kidney size and cortical thinning are often seen especially when the disease progresses. However, kidney size correlates to height, and short persons tend to have small kidneys; thus, kidney size as the only parameter is unreliable.
In infants and young children, the larger relative size of their kidneys leads to increased renal clearance of medications that are eliminated through urine. [32] In preterm neonates and infants, their kidneys are slower to mature and thus are unable to clear as much drug as fully developed kidneys.
The mammalian kidney is the organ that has the most complex vascular blood system compared to other organs. [105] Despite their small size, the kidneys of mammals account for a significant part of the minute volume of blood circulation. [106]