Aims: In this study, Doppler parameters were studied in patients with advanced stage renal disease, and the relationship between Doppler parameters and renal disease stage was investigated. Doppler values were evaluated for a cut-off value between normal and end-stage kidney disease group. Materials and methods: 50 patients with chronic kidney disease and 15 patients belonging to the same age group and with normal serum creatinine levels were comprised of the study and control groups. Resistivity and pulsatality indices were measured at the main renal arteries and interlobular arteries at both sides. Results: Statistically significant differences were found between the PI and RI values obtained from the main renal and interlobular arteries. PI sums were compared with those from the control group, and a cut-off value of 2.15 was found, with a sensitivity of 90% and a specificity of 86.7%. Conclusion: Any increase in the RI and PI values obtained from the main renal and interlobular arteries must bring to mind the possibility of advancing renal damage and interstitial fibrosis. Patients with and without renal parenchymal damage can be differentiated by means of comparing the total PI values obtained from the right and left main renal and interlobular arteries.
References
[1]
Omer, M.A.A., Eljack, A.H., Garalnabi, M.E.M., Mahmoud, M.Z., Elseid, M. and Edam, G.A. (2014) Ultrasonographic Characteristics of Diabetes Impacts in Kidneys’ Morphology. Open Journal of Radiology, 4, 301-308. http://dx.doi.org/10.4236/ojrad.2014.44039
[2]
Meguid El Nahas, A. and Bello, A.K. (2005) Chronic Kidney Disease: The Global Challenge. Lancet, 365, 331-340. http://dx.doi.org/10.1016/S0140-6736(05)17789-7
[3]
Eriksen, B.O. and Ingebretsen, O.C. (2006) The Progression of Chronic Kidney Disease: A 10-Year Population-Based Study of the Effects of Gender and Age. Kidney International, 69, 375-382. http://dx.doi.org/10.1038/sj.ki.5000058
[4]
Clark, L.E. and Khan, I. (2010) Outcomes in CKD: What We Know and What We Need to Know. Nephron Clinical Practice, 114, 95-102. http://dx.doi.org/10.1159/000254381
[5]
Bigé, N., Lévy, P.P., Callard, P., Faintuch, J.M., Chigot, V., Jousselin, V., et al. (2012) Renal Arterial Resistive Index Is Associated with Severe Histological Changes and Poor Renal Outcome during Chronic Kidney Disease. BMC Nephrology, 13, 139. http://dx.doi.org/10.1186/1471-2369-13-139
[6]
Sugiura, T. and Wada, A. (2009) Resistive Index Predicts Renal Prognosis in Chronic Kidney Disease. Health Nephrology Dialysis Transplantation, 24, 2780-2785. http://dx.doi.org/10.1093/ndt/gfp121
[7]
Ghadirpour, A., Tarzamni, M.K., Naghavi-Behzad, M., Abedi-Azar, S., Koushavar, H. and Nezami, N. (2014) Renal vascular Doppler Ultrasonographic Indices and Carotid Artery Intima-Media Thickness in Diabetic Nephropathy. Medical Ultrasonography, 16, 95-99. http://dx.doi.org/10.11152/mu.2013.2066.162.ag1mkt2
[8]
Viazzi, F., Leoncini, G., Derchi, L.E. and Pontremoli, R. (2014) Ultrasound Doppler Renal Resistive Index: A Useful Tool for the Management of the Hypertensive Patient. Journal of Hypertension, 32, 149-153. http://dx.doi.org/10.1097/HJH.0b013e328365b29c
[9]
Stevens, L.A., Coresh, J., Feldman, H.I., Greene, T., Lash, J.P., Nelson, R.G., et al. (2007) Evaluation of the Modification of Diet in Renal Disease Study Equation in a Large Diverse Population. Journal of the American Society of Nephrology, 18, 749-757. http://dx.doi.org/10.1681/ASN.2007020199
[10]
Soker, G., Ozturk, A.B., Gulek, B., Kuscu, F., Dogan, U.B. and Yilmaz, C. (2015) Doppler Ultrasonography Helps Discriminate between Cirrhotic and Non-Cirrhotic Patients with Viral B and C Hepatitis. Diagnostic and Interventional Imaging.
[11]
Dib, F.R., Duarte, G., Sala, M.M., Ferriani, R.A. and Berezowski, A.T. (2003) Prospective Evaluation of Renal Artery Resistance and Pulsatility Indices in Normal Pregnant Women. Ultrasound in Obstetrics & Gynecology, 22, 515-519. http://dx.doi.org/10.1002/uog.240
[12]
Nath, K.A. (1992) Tubulointerstitial Changes as a Major Determinant in the Progression of Renal Damage. American Journal of Kidney Diseases, 20, 1-17. http://dx.doi.org/10.1016/S0272-6386(12)80312-X
[13]
Platt, J.F., Ellis, J.H., Rubin, J.M., DiPietro, M.A. and Sedman, A.B. (1990) Intrarenal Arterial Doppler Sonography in Patients with Nonobstructive Renal Disease: Correlation of Resistive Index with Biopsy Findings. American Journal of Roentgenology, 154, 1223-1227. http://dx.doi.org/10.2214/ajr.154.6.2110732
[14]
Ikee, R., Kobayashi, S., Hemmi, N., Imakiire, T., Suzuki, S. and Miura, S. (2005) Correlation between the Resistive Index by Doppler Ultrasound and Kidney Function and Histology. American Journal of Kidney Diseases, 46, 603-609. http://dx.doi.org/10.1053/j.ajkd.2005.06.006
[15]
Mostbeck, G.H., Kain, R., Mallek, R., Derfler, K., Walter, R., Havelec, L., et al. (1991) Duplex Doppler Sonography in Renal Parenchymal Disease. Histopathologic Correlation. Journal of Ultrasound in Medicine, 10, 189-194.
[16]
Izumi, M., Sugiura, T., Nakamura, H., Nagatoya, K., Imai, E. and Hori, M. (2000) Differential Diagnosis of Prerenal Azotemia from Acute Tubular Necrosis and Prediction of Recovery by Doppler Ultrasound. American Journal of Kidney Diseases, 35, 713-719. http://dx.doi.org/10.1016/S0272-6386(00)70020-5
[17]
Sugiura, T., Nakamori, A., Wada, A. and Fukuhara, Y. (2004) Evaluation of Tubulointerstitial Injury by Doppler Ultrasonography in Glomerular Diseases. Clinical Nephrology, 61, 119-126. http://dx.doi.org/10.5414/CNP61119
[18]
Hanamura, K., Tojo, A., Kinugasa, S., Asaba, K. and Fujita, T. (2012) The Resistive Index Is a Marker of Renal Function, Pathology, Prognosis, and Responsiveness to Steroid Therapy in Chronic Kidney Disease Patients. International Journal of Nephrology, 2012, Article ID: 139565. http://dx.doi.org/10.1155/2012/139565
[19]
Emamian, S.A., Nielsen, M.B., Pedersen, J.F. and Ytte, L. (1993) Kidney Dimensions at Sonography: Correlation with Age, Sex, and Habitus in 665 Adult Volunteers. American Journal of Roentgenology, 160, 83-86. http://dx.doi.org/10.2214/ajr.160.1.8416654
[20]
Miletic, D., Fuckar, Z., Sustic, A., Mozetic, V., Stimac, D. and Zauhar, G. (1998) Sonographic Measurement of Absolute and Relative Renal Length in Adults. Journal of Clinical Ultrasound, 26, 185-189. http://dx.doi.org/10.1002/(SICI)1097-0096(199805)26:4<185::AID-JCU1>3.0.CO;2-9
