ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2021, Vol. 30 ›› Issue (6): 514-519.DOI: 10.3969/j.issn.1006-298X.2021.06.003

Previous Articles     Next Articles

Association of renal three-dimensional ultrasound and histopathological lesions in diabetic nephropathy patients

  

  • Online:2021-12-28 Published:2021-12-27

Abstract:

Objective:To analyze the correlation between renal threedimensional(3D) ultrasound parameters and pathological indicators in diabetic nephropathy patients.
Methodology:A total of 110 patients with type 2 diabetes mellitus complicated with chronic kidney disease were selected and divided into DN group (n=62) and nondiabetic nephropathy group (n=48) according to pathological results of renal biopsy. The relationship between parameters such as renal volume, elastic shear wave velocity (SWV) and renal perfusion obtained by 3D ultrasound and renal histopathological data of two groups was analyzed, including glomerular pathological staging, degree of interstitial fibrosis and tubular atrophy(IFTA), etc. The predictive model for auxiliary diagnosis of diabetic nephropathy was established by logistic regression.
Results:There was statistically significant difference in age, course of diabetes mellitus, total cholesterol, retinopathy and peripheral neuropathy (P<005) between DN group and NDRD group. The
 volume of both kidncys in DN group was larger than that in NDRD group (The P value of left kidney and right kidney was 0089 and 0009 respectively). The SWV value of renal cortex in DN group was significantly higher than that in NDRD group (P<005), the SWV values of left renal cortex in IFTA2 and IFTA3 patients were significantly higher than those in IFTA1 group (P<005), also the SWV value of left kidney in glomerular pathological stage 3 and 4 was significantly higher than that in stage 2 (P<005).The VI and VFI values of both kidneys in DN group were lower than those in NDRD group (P<005).All clinical and ultrasound data were included for linear filter, removing parameters with low diagnostic efficiency. AGE, diabetes duration (HIS), retinopathy (DR), total cholesterol (TC), and bilateral renal cortical elastic average (SWV) were finally included to build the prediction model for diagnosis of DN: Logit (DN)=0067×age-0113×HIS+1710×DR+0475×TC-3538×SWV-1937, area under ROC curve (AUC)=0831,95%CI 0752~0910.
Conclusion:The combination of renal 3D ultrasound with clinical indicators is helpful for the diagnosis of diabetic nephropathy in patients with contraindications and high risks for renal biopsy.