Diagnostic Value Of Renal Resistive Index In Predicting Histopathological Severity Of Diabetic Nephropathy In Type 2 Diabetes Mellitus

Abstract

Background: Diabetic nephropathy is considered as one of the most severe complications of Type 2 Diabetes Mellitus, and is a major cause of chronic kidney disease and end-stage renal failure in the global context. The early signs of renal injury are a significant clinical problem because traditional biomarkers, including estimated glomerular filtration rate (eGFR) and albuminuria, mainly indicate functional deficiency at late stages of the disease, but not the early structural alterations.

Objective: This study was intended to determine the usefulness of the Renal Resistive Index (RI), which is a Doppler ultrasonography-derived index, in determining the severity of diabetic nephropathy.

Methodology: This cross-sectional study was analytical involving 40 patients with Type 2 Diabetes Mellitus. The department of Radiology and Nephrology at Mayo Hospital, Lahore was used as the source of data. The SPSS version 27 was used to examine demographic, clinical, biochemical and Doppler parameters. The descriptive statistics, correlation analysis, and linear regression were used to evaluate the correlation between RI and parameters of renal functions.

Results: The average age of the patients was 48.6 and the standard deviation was 7.9 with a male majority (67.5%). The average life span with diabetes was 7.6 years with a standard deviation of

2.2. High serum creatinine (2.05 ± 1.18 mg/dL) and low eGFR (67.2 ± 23.8 mL/min) revealed the presence of poor renal functioning. A majority of patients (62.5%) had high RI values (>0.80). The rise of RI was statistically significant as the severity of albuminuria rose (p < 0.001). Positive correlations were observed to be strong between RI and serum creatinine (r = 0.87) and microalbumin (r = 0.79), whereas a negative correlation was found to be strong between RI and eGFR (r = -0.91). RI was also confirmed as an important predictor of renal dysfunction by regression analysis.

Conclusion: To summarize, Renal Resistive Index is an effective non-invasive biomarker that is highly correlated with renal functioning and severity of the disease in diabetic nephropathy. Its adoption as a standard clinical procedure can improve the process of early disease identification, risk assessment, and disease progression tracking.