Clinical Profile of Diabetic Nephropathy and Correlation With Intrarenal Resistivity Index by Duplex Ultrasonography

Abstract

Background: To study the clinical profile of Diabetic nephropathy and the correlation of intrarenal resistivity index with parameters of renal dysfunction like Glomerular filtration rate, Serum Creatinine, micro and macroalbuminuria.

Methods: This was a cross sectional observational study carried out over a period of 2 years. Patients of type 2 Diabetes as per WHO criteria who had nephropathy were included. A Detailed history was taken and clinical examination was done. Urine routine and microscopic examination and biochemical investigations were done. Patients were subjected to ultrasound of kidneys and renal doppler.

Results: A total of 160 patients of type 2 diabetes with diabetic nephropathy were studied. They were divided into two groups based on intrarenal resistivity index (IRI) by duplex ultrasonography as Group I: Patients with IRI > 0.70 (n = 72) and Group II: Patients with IRI > 0.70 (n = 88). Mean age in group I was 50.42 4.89 and in group II was 60.34 7.92 (P = 0.000). Mean duration of diabetes mellitus in group I was 4.57 3.65 years and 11.25 6.97 years in group II. Mean systolic BP in group II was 144.09 16.79 mmHg whereas in group I it was 128.47 13.07 mmHg, 80.55% in group I were in the early stage of nephropathy whereas 69.32% patients of group II were in established stage of nephropathy. On multivariate analysis, factors which independently affected IRI were age, Hypertension, Complications - Coronary artery disease and retinopathy, Macroalbuminuria, Decreased creatinine clearance.

Conclusions: Intrarenal resistivity index as assessed by duplex ultrasonography is a non-invasive parameter that can be correlated with the clinical profile and biochemical parameters of renal dysfunction type II diabetes mellitus with diabetic nephropathy.




doi: http://dx.doi.org/10.4021/wjnu41w