Subtle morpho-functional kidney changes in type-2 diabetes mellitus patients: A duplex ultrasound assessment

Abstract

Objectives: Diabetes mellitus (DM) is a common endocrine disease with serious effects on multiple organs including the kidneys. This study aimed to investigate the subtle effects of type 2 DM (T2DM) on the kidneys.
 Methods: This was a prospective case-control study conducted in the Radiology Department of University of Science and Technology Hospital (USTH) campus, Sana’a, Republic of Yemen, from 1 January 2020 to 31 November 2020. The renal length (RL), renal width (RW), resistive index (RI), and pulsatility index (PI) were prospectively measured in patients with T2DM and healthy controls. The results were compared using the independent samples t-test. Comparisons were likewise performed between patients with controlled DM and patients with uncontrolled DM.
 Results: A total of hundred individuals, 50 diabetic patients and 50 controls, were enrolled in this study. Their mean age was 54 ± 7.88 years (range: 40–75 years). The RL, RI, and PI of both kidneys were significantly higher in T2DM than in the control group. Moreover, the RL, RI, PI and creatinine were slightly higher in patients with uncontrolled than in those with controlled DM.
 Conclusion: T2DM has significant accentuating effects on the RL, RI and PI associated with low effective renal plasma flow, even before acute kidney injury or chronic kidney disease diagnosis, which may be attenuated by careful regulation of DM. Ultrasound Doppler is a highly valuable imaging modality for evaluating the subtle effects of T2DM on kidney dimensions and blood flow. The RI can be implemented as a tool for the early diagnosis of kidney disease and contribute to slowing the disease progression and preventing renal failure.
 doi: https://doi.org/10.12669/pjms.38.3.4699
 How to cite this:Alareqi AA, Alshoabi SA, Qurashi AA, Hamid AM. Subtle morpho-functional kidney changes in type-2 diabetes mellitus patients: A duplex ultrasound assessment. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4699
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Role of renal doppler ultrasonography in evaluating renal haemodynamics in diabetic patients and its correlation with laboratory parameters (serum HbA1C and serum creatinine)

“…The findings of our study are comparable with a similar study conducted by Dawha et 6,[14][15][16][17] In our study, it was observed that 47.1% of diabetic patients with normal serum creatinine had a high Pulsatility index and 100% of diabetic patients with high serum creatinine had an elevated Pulsatility index. We found out that there was a strong, positive correlation between PI and serum creatinine in the study population, which was found to be statistically significant (r = .817, p<0.001).…”

“…The findings in our study were comparable to the study conducted by Alareqi et al, who found a statistically significant correlation between the two parameters. 15 Based on the findings, we can say that better glycaemic control (lower HbA1c) is associated with better renal outcomes as predicted by the Pulsatility index and vice versa. And that in patients with poor glycaemic control (higher HbA1c), the Pulsatility index is higher suggesting poorer renal status.…”

“…In similar studies conducted by Pelliccia et al, Youssef et al, Kim et al, and Alareqi et al, the Renal resistive index showed a positive correlation with HbA1c levels which was found to be statistically significant. [12][13][14][15] From this observation, we can derive a conclusion that a higher Resistive Index is seen in patients with poorer glycaemic control and implied poorer renal status.…”

Investigation Study of Ultrasound Practitioners’ Awareness about Artefacts of Hepatobiliary Imaging in Almadinah Almunawwarah

“…1 Ultrasonography is a diagnostic imaging technique using ultrasound waves to visualise the body structures, including soft tissues, such as liver, muscles, and blood vessels. 1,2 It is a highly valuable imaging modality in assessing liver parenchyma and detecting liver lesions by providing accurate diagnostic information and detecting complications. 3 It is an ionising radiation free technique, real time, widely available, non-invasive, and low cost.…”