Biomedical Research

Objective: To explore the relationship between kidney size and Resistance Index (RI) and provide valuable reference to the diagnosis of Diabetic Nephropathy (DN) by observing changes in kidney size, morphology, structure and renal artery resistance indexes (RI) in patients with Diabetes Mellitus (DM) using color Doppler ultrasound.

Methods: 140 patients with DM were enrolled and divided into two groups according to the course of disease. Patients with a disease duration less than 5 y were set as group A (n=70), and patients with a disease history more than 5 y were set as group B (n=70). At the same time, 60 healthy subjects were chosen as control group. Levels of cystatin C (Cys-C), and high sensitivity C-reactive Protein (hs-CRP) in serum, Beta-2 Microglobulin (β2-MG) and urinary microalbumin (U-mAlb) in urine and other laboratory indexes were compared between groups. Changes of kidney size and renal artery resistance index were compared between subjects.

Results: Compared with control group, levels of Cys-C and hs-CRP in serum, 2-MG and U-mAlb in urine were significantly higher in group A and B (P<0.05), but there were no significant differences between the group A and group B on these items (P>0.05). In group B, there were 16 cases (22.9%) of renal swelling (9-12 y of disease duration) and the levels of RI in all renal arteries increased, while microalbuminuria was positive in 9 cases. The average kidney indexes (length, width, area) of group B was significantly larger than those of group A and control group (P<0.05), but there was no significant difference between group A and control group (P>0.05). The RI in group B was significantly higher than that in group A and control group (P<0.05). There was a positive linear correlation between the size and renal arterial RI in group B (r=0.832, P<0.05).

Conclusion: Color Doppler ultrasonography is of great value in patients with DM. It can indicate the size and hemodynamics of the kidney, and can be used for the early diagnosis of Diabetic Nephropathy (DN).

Author(s): Shuhao Deng, Quan Jiang, Yicheng Zhu, Yuan Zhang
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