Role of Renal Resistive Index in early detection of Diabetic Nephropathy in Type II Diabetic Patients

Ali, Nihal O.Youssif Ali; Khalaf-Awad, Ahmed M.; HM, Fayed; Hashim, Abd Elkader Ahmed; Abd ElRazik, Ghada M.

doi:10.21608/svuijm.2023.236371.1700

Role of Renal Resistive Index in early detection of Diabetic Nephropathy in Type II Diabetic Patients

Document Type : Original research articles

Authors

¹ Diagnostic and Intervention Radiology Department, Faculty of Medicine-South Valley University, Qena, Egypt

² Clinical and Chemical Pathology, Qena Faculty of Medicine, South Valley University,Qena, Egypt

³ Internal Medicine Department, Faculty of Medicine, South Valley University, Qena, Egypt

10.21608/svuijm.2023.236371.1700

Abstract

Background: Diabetic nephropathy (DN) burdens health services; renal resistive index (RI) indicates atherosclerotic changes.
Objectives: Assessing renal artery RI for early detection of DN in type II diabetes (T2DM) patients.
Patients and methods: A cross-sectional study analyzed 82 T2DM patients, divided into two subgroups 27 normoalbuminuric (10 males; 17 females), 55 hyper-albuminuric (26 males; 29 females)), and 18 age and sex-matched healthy volunteers. All participants were evaluated by clinical examination, gray-scale renal ultrasound, Doppler evaluation of renal RI, and laboratory evaluation of glycemic control and renal functions.
Results: T2DM without DN had a mean age of 48.6±3.9 years, while T2DM with DN had a mean age of 52.9 ±6.3 years. T2DM with DN significantly increased BMI and higher HbA1c levels compared to T2DM without DN and normal groups. T2DM patients with DN have higher renal artery RI compared to the control group. RI values showed a positive correlation with albuminuria. Renal impairment and RI increase with disease duration over 5 years. T2DM patients with DN have significantly higher renal RI (0.71 ±0.015), compared with T2DM without DN (0.639 ±0.017), and compared to the control group (0.56 ±0.02) (p < 0.001). The RI at a cutoff level of > 0.68 had an AUC of 1.0, which can discriminate T2DM with DN from that without DN with 100% in all sensitivity, specificity, PPV, and NPV, (P<0.001).
Conclusion: Poor glycemic control and obesity negatively impact renal function in T2DM; renal RI >0.68 is a useful test for early diabetic nephropathy evaluation.

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