Value of renal cortical thickness as a predictor of renal function impairment in chronic renal disease patients

Abstract

ObjectiveTo determine the presence of linear relationship between renal cortical thickness, bipolar length, and parenchymal thickness in chronic kidney disease patients presenting with different estimated glomerular filtration rates (GFRs) and to assess the reproducibility of these measurements using ultrasonography.Materials and MethodsUltrasonography was performed in 54 chronic renal failure patients. The scans were performed by two independent and blinded radiologists. The estimated GFR was calculated using the Cockcroft-Gault equation. Interobserver agreement was calculated and a linear correlation coefficient (r) was determined in order to establish the relationship between the different renal measurements and estimated GFR.ResultsThe correlation between GFR and measurements of renal cortical thickness, bipolar length, and parenchymal thickness was, respectively, moderate (r = 0.478; p < 0.001), poor (r = 0.380; p = 0.004), and poor (r = 0.277; p = 0.116). The interobserver agreement was considered excellent (0.754) for measurements of cortical thickness and bipolar length (0.833), and satisfactory for parenchymal thickness (0.523).ConclusionThe interobserver reproducibility for renal measurements obtained was good. A moderate correlation was observed between estimated GFR and cortical thickness, but bipolar length and parenchymal thickness were poorly correlated.

Sonographic Grading of Renal Cortical Echogenicity and Raised Serum Creatinine in Patients With Chronic Kidney Disease

“…They also stated that the measurement of the thickness of the renal parenchyma, which is still widely used in the clinical practice to infer some chronic nephropathies should be discouraged, since it showed no statistical correlation with renal function impairment and therefore it is useless in this context. 6 Our present study further confirmed this finding.…”

“…The findings were closely consistent with those of Yamashita et al who found the mean cortical thickness to be 7.1 mm in their cases. 6 Beland et al reported a mean cortical thickness of 5.9 mm in CKD patients in their study. 17 Raised renal cortical echogenicity was reported in all the patients with CKD in this present study.…”

“…This correlated well with the findings of Yamashita et al, in which the average renal length was 9.5 cm in CKD patients (Range 6.99 -13 cm; SD = 1.25 cm). 6 Normal parenchymal thickness ranges from 1.5 -2 cm. 9 The mean parenchymal thickness obtained in the present study was 1.77 cm (Range 1 -2.35 cms; SD=0.3 cm).…”

“…6 The measurement of serum creatinine has been the traditional approach to assessing CKD. eGFR derived from formulas such as the Modification of Diet in Renal Disease (MDRD) equation is superior to serum creatinine alone in the diagnosis of CKD.…”

Correlation of Ultrasound Parameters with Serum Creatinine in Renal Parenchymal Disease

“…To obtain renal measurements as a prognostic factor. Such measurements are important since in most cases CKD leads to a common final-stage condition characterized by small kidneys, cortical and parenchymal thinning (indicating atrophy) and hyperechogenicity indicating sclerosis and fibrosis (small, dense, echogenic kidneys); such findings indicate disease irreversibility and poor prognosis 6 .…”