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The renal parenchyma—evaluation of a novel ultrasound measurement to assess fetal renal development: protocol for an observational longitudinal study
  1. Sonja Brennan1,2,
  2. Michal Schneider3,
  3. David Watson2,4,
  4. Yogavijayan Kandasamy2,5,6,
  5. Donna Rudd2
  1. 1 Ultrasound Department, The Townsville Hospital, Townsville, Queensland, Australia
  2. 2 College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
  3. 3 Medical Imaging & Radiation Sciences, Monash University, Melbourne, Victoria, Australia
  4. 4 Department of Obstetrics and Gynaecology, The Townsville Hospital, Townsville, Queensland, Australia
  5. 5 Department of Neonatology, The Townsville Hospital, Townsville, Queensland, Australia
  6. 6 Mothers and Babies Research Centre, Hunter Medical Research Institute, John Hunter Hospital, The University of Newcastle, Newcastle, Australia
  1. Correspondence to Sonja Brennan; sonja.brennan{at}


Introduction Disorders of fetal growth, such as intrauterine growth restriction (IUGR) and large for gestational age (LGA), have been found to have a profound effect on the development of the fetal kidney. Abnormal kidney development is associated with hypertension and chronic kidney disease later in life. This study will use a novel ultrasound measurement to assess the renal parenchymal growth and kidney arterial blood flow in the fetus to evaluate the development of the fetal kidneys and provide an indirect estimate of nephron number. Measurements in normally grown, IUGR and LGA fetuses will be compared to determine if changes in renal parenchymal growth can be detected in utero.

Methods and analysis This longitudinal, prospective, observational study will be conducted over 12 months in the Ultrasound Department of the Townsville Hospital, Australia. The study will compare fetal renal parenchymal thickness (RPT) and renal artery Doppler flow between IUGR fetuses and appropriately grown fetuses, and LGA fetuses and appropriately grown fetuses between 16 and 40 weeks. The fetal RPT to renal volume ratio will also be compared, and correlations between RPT, renal parenchymal echogenicity, fetal Doppler indices and amniotic fluid levels will be analysed.

Ethics and dissemination This study was approved by the Townsville Health District Human Research Ethics Committee. The study results will form part of a thesis and will be published in peer-reviewed journals and disseminated at international conferences.

  • fetal kidney
  • renal
  • renal parenchyma
  • renal artery doppler
  • ultrasound
  • obstetric ultrasonography

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  • Contributors SB conceived the study and drafted the study design under the supervision of YK, DW, DR and MS. All authors contributed to the conception, design and development of the study protocol. MS provided her expertise for the study design, ethics and critical revision of the manuscript. DW provided his expertise for the ultrasound protocol, recruitment of participants and revision of the protocol. YK provided his expertise for ethics, statistics and drafting of the study protocol. DR provided her expertise for the study design, data management and analysis. All authors approved the final version and agree to be accountable for the contents and integrity of this manuscript.

  • Funding This study is partly funded by a Townsville Hospital and Health Service Research Grant.

  • Competing interests None declared.

  • Ethics approval This study was approved by the Townsville Health District Human Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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