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Year :2019
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Month :
July-August
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Volume :
8
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Issue :
3
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Page :
RO31 - RO35
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Role of Ultrasound and Colour Doppler in Diabetic Nephropathy-Correlation with Biochemical Parameters
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Correspondence Address :
Sai Shankar Mankuzhy Gopalakrishnan, Padhmini Balasubramaniam, koukutla srivenkat reddy,
Dr. Padhmini Balasubramaniam,
S2, Malar daffodils, Jayamurthy Raja Nagar, Bharathiyar, 3rd Cross-street, Puducherry, India.
E-mail: drbpadhmini@gmail.com
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Introduction: Introduction: Ultrasound and Doppler are non-invasive modalities for evaluation of renal diseases. Renal sonography has been used fairly routinely in patients with azotemia to exclude possible obstructive uropathy, to measure the size of kidneys and to evaluate the parenchymal echogenicity of the kidney. Doppler is also used in evaluation of renal vascular resistance by using Doppler indices like resistive index in various systemic conditions like Diabetes mellitus, Systemic hypertension. Diabetic nephropathy is a relatively common form of chronic renal disease. It is the most frequent microvascular complication in diabetic patients.
Aim: To evaluate renal sono-morphological characteristics using grey scale ultrasound, renal vascular resistance using Doppler and correlating with biochemical parameters like Fasting Blood Sugar (FBS), Blood urea, Serum creatinine, Total cholesterol, Triglyceride and urine albumin in patients with diabetic renal disease.
Materials and Methods: This cross-sectional study was done in the Department of Radiology, Aarupadai Veedu Medical College, Puducherry, India. Conventional grey scale ultrasound and doppler evaluation of both kidneys were performed in 50 diabetic patients. Renal parameters like renal length, renal parenchymal thickness, renal cortical echogenicity, intra-renal resistive index and biochemical parameters like blood sugar, lipid profile and urine protein were recorded in all the diabetic patients. For purpose of comparison, the patients were subdivided into preclinical, incipient nephropathy, overt nephropathy and renal failure subgroups based on stage of diabetic renal disease. The results were presented in numbers and percentages for categorical data and average and SD for continuous data. Chi-square test of significance, One way Analysis of Variance (ANOVA), Pearson Correlation Coefficient was used (SPSS-version 24).
Results: Renal length and parenchymal thickness showed a progressive decrease with progression of diabetic renal disease. An 81% of patients in the preclinical group had normal renal parenchymal echogenicity. None of the other three subgroups had normal parenchymal echogenicity. A total of 31% and 70% of the patients in overt nephropathy and renal failure subgroups had hyperechogenicity (grade II) changes in renal parenchyma. Renal length and parenchymal thickness showed no correlation with serum creatinine and urine protein. The Slightly increased mean resistive index values (>0.7) were obtained in the subgroups I (preclinical) which suggests doppler ultrasound can detect diabetic renal disease in this early stage. A progressive increase in resistive index values was noted with progression of diabetic nephropathy. Resistive index values showed a positive correlation with blood urea nitrogen and serum creatinine, this correlation was found to be statistically significant.
Conclusion: Renal length and parenchymal thickness are unreliable indicators of the disease severity in diabetic renal disease. The positive correlation of intra-renal resistive index and renal echogenicity with most of the biochemical parameters, though not statistically significant, indicates a complementary role of this doppler index in diabetic renal disease.
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