ROLE OF DUPLEX DOPPLER ULTRASOUND IN ASSESSMENT OF RENAL ARTERY IN DIABETIC NEPHROPATHY PATIENTS

Abstract

Background: Diabetic nephropathy is a serious complication of diabetes and it is one of the primary source of renal failure. Duplex Doppler ultrasound is reliable and effective diagnostic tool for evaluating renal blood flow by using renal Doppler indices including peak systolic velocity, end diastolic velocity and resistive index.

Objectives: The aim of this study is to evaluate the role of duplex Doppler ultrasound in assessment of renal artery in diabetic nephropathy patients.

Methods: Total number of 43 patients were included in this descriptive cross-sectional study.  A non-probability sampling technique was used for this study. Data were collected based on the questionnaire included patient’s age, gender, medical history, laboratory findings, grey-scale ultrasound and Doppler ultrasound parameters. Data were analyzed and verified using Statistical Package for the Social Sciences (SPSS) software. Pearson’s correlation test was applied and a p-value (< 0.05) was considered statistically significant.

Results: Females predominated 64.7% with mean age 55.49±6.19 years. A positive correlation was found between the renal resistive index and serum creatinine, serum urea, BUN, uric acid (r= 0.970-0.989, p <0.001), along a strong negative correlation with estimated glomerular filtration rate (r= -0.993 to -0.994, p <0.001). Increased resistive index positively associated with the long-term duration of diabetes (14.02 ± 4.31), hypertension (9.70±3.17) and chronic renal failure (5.16±2.00), (r= 0.972-0.978, p< 0.001). Progressive renal parenchymal damage often characterized on grey-scale ultrasound by increased echogenicity (Grades III/IV) and reduced renal length.

Conclusion: There is positive correlation between elevated renal resistive index and biochemical markers including uric acid, BUN, urea, serum creatinine and decreased estimated glomerular filtration rate. The association between higher renal resistive index, longer disease duration and structural changes like reduced renal length confirms its utility in assessing the progression of diabetic nephropathy.