Abstract
Background: Malnutrition remains the most critical public health crisis in low- and middle-income countries, particularly in South Asia. Its systemic effects extend beyond anthropometric deficits to impair organ-level development, including renal growth. Kidney size, measurable non-invasively by ultrasonography, represents a sensitive marker of somatic growth and nephron endowment.
Objectives: To compare kidney dimensions between malnourished and healthy children aged 6–60 months and to assess the correlation between renal parameters and anthropometric variables including age, weight, height, and body surface area (BSA).
Methods: A hospital-based cross-sectional study enrolled 41 malnourished children (cases) and 40 healthy age-matched controls. Bilateral kidney dimensions (length and width) were assessed via B-mode ultrasonography. Anthropometric data were collected, and severity of malnutrition was classified using WHO weight-for-height z-scores (WHZ), mid-upper arm circumference (MUAC), and the presence of bilateral pitting oedema. Statistical analysis included Mann-Whitney U tests for group comparisons and Spearman's rank correlation for anthropometric associations.
Results: Malnourished children demonstrated significantly reduced bilateral kidney lengths compared to healthy controls (left: 6.0 cm vs. 6.55 cm, p<0.001; right: 5.9 cm vs. 6.5 cm, p=0.001), while kidney widths did not differ significantly. Malnourished children weighed 40% less, were 16% shorter, and had 30% reduced BSA compared to controls (all p<0.001). In healthy children, kidney length correlated significantly with age, weight, height, and BSA. In malnourished children, correlations were reduced and age lost its predictive significance for renal length, with weight and BSA emerging as the dominant anthropometric correlates.
Conclusion: Malnutrition is associated with significantly smaller kidney lengths, reflecting compromised renal growth and potentially reduced nephron endowment. The decoupling of age from renal length in malnourished children suggests nutritional status, rather than chronological age, governs renal growth trajectories in this population. These findings have important implications for long-term cardiorenal risk in nutritionally vulnerable paediatric populations