Renal duplex ultrasonography among adult native Nigerian diabetics and diabetic nephropathy population
Article Sidebar
Views | PDF/EPUB Downloads:
5
/ 0
/ 0
Main Article Content
Abstract
Background: Diabetes mellitus (DM) is a serious global health problem with grave socioeconomic impact and debilitating complications especially diabetic nephropathy (DN). This study evaluated the usefulness of renal parenchymal and vascular sonography among three groups-diabetics with nephropathy, diabetes with no evidence of nephropathy and nondiabetics.
Materials and Methods: The renal volume, parenchymal changes, and intrarenal vascular indices of three groups of participants (Group A - Diabetic with nephropathy; Group B - diabetic without nephropathy; and Group C - nondiabetic controls) were assessed using B-mode and Duplex ultrasonography.
Results: The difference in the means of resistance index (RI) and pulsatility index (PI) in the diabetic patients (Group A and Group B) was significantly higher compared to the controls(RI mean ± standard deviation [SD]: Group A diabetic patients, 0.71 ± 0.11 cm3 ; Group B diabetics, 0.68 ± 0.08 cm3 ; controls, 0.62 ± 0.07 cm3; P < 0.0001); (PI ± SD: Group A diabetic patients, 1.22 ± 0.25 cm3 ; Group B diabetics, 1.16 ± 0.29 cm3; controls, 1.03 ± 0.23 cm3 ; P = 0.003). The mean renal volume among DM patients (Group A and Group B)
were higher than in nondiabetic controls, (mean renal volume ± SD: Group A DM patients with nephropathy, 13.99 ± 3.95 cm3 , the diabetic group without DM patients 13.39 ± 4.59 cm3 , controls 12.05 ± 3.39 cm3).
Conclusion: This study showed that renal RI and PI were significantly increased in patients with diabetes than in healthy controls with a trend of increase from controls to DM without nephropathy to DM with nephropathy. Duplex ultrasonography is useful for the clinical evaluation of diabetes and DN.
Downloads
Article Details
Section
How to Cite
References
1. Kyari F, Tafida A, Sivasubramaniam S, Murthy GV, Peto T, Gilbert CE, et al. Prevalence and risk factors for diabetes and diabetic retinopathy:
Results from the Nigeria national blindness and visual impairment survey. BMC Public Health 2014;14:1299.
2. Ogbera AO, Ekpebegh C. Diabetes mellitus in Nigeria: The past, present and future. World J Diabetes 2014;5:905‑11.
3. MichaelJF. Microvascular and macrovascular complications of diabetes. Clin Diabetes 2008;26:77‑82.
4. Townsend R. Mechanism of Diabetic Nephropathy. Renal and Urology News: 2007;1‑4.
5. Carmines PK. The renal vascular response to diabetes. Curr Opin Nephrol Hypertens 2010;19:85‑90.
6. Milovanceva‑Popovska M, Dzikova S. Progression of diabetic nephropathy: Value of intrarenal resistive index (RI). Prilozi
2007;28:69‑79.
7. Saif A, Soliman NA, Abdel‑Hameed A. Early evaluation of renal hemodynamic alterations in type I diabetes mellitus with duplex ultrasound. Saudi J Kidney Dis Transpl 2010;21:295‑9.
8. Petersen LJ, Petersen JR, Talleruphuus U, Ladefoged SD, Mehlsen J, Jensen HA, et al. The pulsatility index and the resistive index in renal arteries. Associations with long‑term progression in chronic renal failure. Nephrol Dial Transplant 1997;12:1376‑80.
9. Dawha S, Ayoola O, Ibitoye B, Ikem R, Arogundade F. An assessment of factors influencing resistivity and pulsatility indices in diabetes mellitus. Trop J Nephrol 2017;9:15‑22.
10. Kasiulevivius V, Sapoka V, Filipaviviute R. Sample size calculation in epidemiological studies. Gerontologija 2006;7:225‑31.
11. KDOQI clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease. Am J Kidney Dis 2007;49:S12‑154.
12. National Institute of Diabetes and Digestive Disease. Glomerular Filtration Rate (GFR) Calculators. Available from: https://www.niddk.nih.gov/health‑information/health‑communication‑programs/nkdep/lab‑evaluation/gfr/estimating/Pages/estimating.aspx. [Last accessed on 2018 Oct 14].
13. Platt JF, Ellis JH, Rubin JM, DiPietro MA, Sedman AB. Intrarenal arterial Doppler sonography in patients with nonobstructive renal disease: Correlation of resistive index with biopsy findings. AJR Am J Roentgenol 1990;154:1223‑7.
14. Kaya M. The Evaluation of Renal Hemodynamics with Doppler Ultrasonography, Hemodynamics. In: Seda Artis A, editor. IntechOpen, 2012. DOI: 10.5772/36263. Available from: https://www.intechopen.com/books/hemodynamics-new-diagnostic-and-therapeutic-approaches/the-evaluation-of-renal-hemodynamics-with-renal-doppler-ultrasonography. [Last accessed on 2018 Oct 14].
15. Saeed Z, Mirza W, Sayani R, Sheikh A, Yazdani I, Hussain SA. Sonographic measurement of renal dimensions in adults and its correlates. Int J Collab Res Int Med Public Health 2012;4:1626‑41.
16. Singh GR, Hoy WE. Kidney volume, blood pressure, and albuminuria: Findings in an Australian aboriginal community. Am J Kidney Dis 2004;43:254‑9.
17. Brkljacić B, Mrzljak V, Drinković I, Soldo D, Sabljar‑Matovinović M, Hebrang A, et al. Renal vascular resistance in diabetic nephropathy: Duplex Doppler US evaluation. Radiology 1994;192:549‑54.
18. Ishimura E, Nishizawa Y, Kawagishi T, Okuno Y, Kogawa K, Fukumoto S, et al. Intrarenal hemodynamic abnormalities in diabetic nephropathy measured by duplex Doppler sonography. Kidney Int 1997;51:1920‑7.
19. Kawai T, Kamide K, Onishi M, Yamamoto‑Hanasaki H, Baba Y, Hongyo K, et al. Usefulness of the resistive index in renal Doppler ultrasonography as an indicator of vascular damage in patients with risks of atherosclerosis. Nephrol Dial Transplant 2011;26:3256‑62.
20. Baxter GM, Sidhu PS. Ultrasound of the Urogenital System. New York, Stuttgart: Thieme; 2006. p. 286.
21. Mancini M, Masulli M, Liuzzi R, Mainenti PP, Ragucci M, Maurea S, et al. Renal duplex sonographic evaluation of type 2 diabetic patients. J Ultrasound Med 2013;32:1033‑40.
22. Koenhemsi L, Toydemir S, Ucmak M, Gonul R, Or ME. Evaluation of early renal disease in bitches with pyometra based on renal Doppler measurements. Vet Med 2016;61:344‑7.
23. Radermacher J, Mengel M, Ellis S, Stuht S, Hiss M, Schwarz A, et al. The renal arterial resistance index and renal allograft survival. N Engl J Med 2003;349:115‑24.
24. Youssef DM, Fawzy FM. Value of renal resistive index as an early marker of diabetic nephropathy in children with type‑1 diabetes mellitus. Saudi J Kidney Dis Transpl 2012;23:985‑92.