Publication: Correlation between Sonoelastographic, Doppler and Histopathological Findings in Chronic Kidney Disease Patients in Tertiary Care Centre
Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Ultrasound (USG) with Doppler examination of intrarenal vessels is the imaging
modality of choice employed in patients with renal failure and is commonly
performed early in the clinical course. The pulsatility index (PI) and the resistive
index (RI) of downstream renal artery have been found to correlate with renal
vascular resistance, filtration fraction and effective renal plasma flow in chronic renal
failure. Pathological process in any tissues alters their elastic properties which can be
assessed non-invasively through newer technique like elastography.
Objective
To correlate the findings obtained by sonoelastographic, doppler and histopathological
studies in chronic kidney disease patients.
Method
Study was done in 146 patients referred to Department of Radiodiagnosis and
Imaging, TUTH for native renal biopsy. Renal sonographic morphology (length,
echogenicity, cortical thickness), Sonoelastography (Young’s modulus) and Doppler
parameters (peak systolic velocity, resistive index) were assessed. The grading of
estimated GFR (eGFR) was calculated based on chronic kidney disease (CKD) criteria.
Result
Among 146 patients, 63 (43.2%) were females and 83 (56.8%) were males. Maximum
patients were in age group of 41-50 years (25.3%) followed by age group 51-60 years
(24%). Mean age of patient was 42.06±14.70 for males and 39.57±12.54 females.
Maximum mean Young’s modulus was seen in eGFR stage G1 with 46.57±19.51
kPa followed by in stage G3a with 36.46±10.01 kPa and observed to be statistically
non-significant (p=0.172). However, statistical significance difference was noted
between the resistive index and elastographic measurement of Young’s modulus
(r=0.462, p=0.0001). Minimum mean cortical thickness was seen in eGFR stage G5
with 4.42±1.48 mm followed by stage G4 with 5.57±1.24 mm (p= 0.0001). Cortical
thickness is decreasing as eGFR stage was increasing in our study (p=0.0001).
Resistive index is increasing with decrease in renal size (r=-0.202, p=0.015).
Conclusion
Ultrasonography along with doppler study and elastography have limited role in
diagnosing the pathology of chronic kidney disease, however, it has significant role
in the disease progression.
KEY WORDS
Chronic kidney disease, Doppler, Elastography, Resistive index, Ultrasonography
Description
Jha SK,1 Lohani B,2 Pant AD,3 Chataut D,2 Regmi D,1 Bhatta U,4 Gautam N,5 Jha G6
1Department of Radiology
Kanti Children’s Hospital
Maharajgunj, Kathmandu, Nepal
2Department of Radiology and Imaging
Maharajgunj Multple Campus
TU Teaching Hospital
Maharagunj, Kathmandu, Nepal
3Department of Pathology
Maharajgunj Multple Campus
TU Teaching Hospital
Maharagunj, Kathmandu, Nepal
4Department of Pathology
Kanti Children’s Hospital
Maharajgunj, Kathmandu, Nepal
5Department of Biochemistry
Universal College of Medical Sciences (UCMS)
Bhairahawa, Nepal
6Patan Academy of Health Sciences
Patan, Nepal
Keywords
Chronic kidney disease, Doppler, Elastography, Resistive index, Ultrasonography