DUPLEX SONOGRAPHY FINDINGS IN ESTABLISHED CASES OF DIABETIC NEPHROPATHY- A DESCRIPTIVE STUDY OVER A PERIOD OF SIX MONTHS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 61
Abstract
BACKGROUND Diabetic nephropathy (Nephropatia diabetica) also known as Kimmelstiel-Wilson syndrome and intercapillary glomerulonephritis, is a progressive kidney disease caused by angiopathy of capillaries in kidney glomeruli. It is characterised by nephrotic syndrome and nodular glomerulosclerosis. It is due to longstanding diabetes mellitus and is a prime cause of dialysis in modern society. Objectives – To elucidate different duplex sonographic findings in patients presenting with diabetic nephropathy. MATERIALS AND METHODS A six-month descriptive study was conducted from December 2016 to May 2017 and data on findings of duplex sonography was obtained. Patients with established diagnosis of diabetic nephropathy presented in Department of Radiology at Patna Medical College and Hospital, Patna from December 2016 to May 2017 were included in the present study. A total of 76 patients presented to our department between the given period of time who then underwent duplex sonography scan, performed by one of experienced radiologist in our department. The inclusion criteria for analysis were the patients who had biochemically proven albuminuria i.e. urine albumin > 30 mg/day on at least 2 days 3 to 6 months apart and elevated serum creatinine value i.e. serum creatinine > 1.5 mg/dL. All the patients underwent duplex Doppler for bilateral kidneys. USG & Colour Doppler study is carried out by GE Logiq P3 model of USG machine using 4-5.5 MHz & 7.5-12 MHz probe. RESULTS 76 patients were studied with established diagnosis of diabetic nephropathy with a mean age of 50.6 yrs. ± 10.8 (range 31 yrs. to 70 yrs.). In our study, all the 76 patients had albuminuria and deranged serum creatinine levels i.e.> 1.5 mg/dL. The results were interpreted in the form of number of kidneys analysed. Out of 152 kidneys, 106 kidneys (69.7%) showed increased resistivity index, 64 kidneys (42.1%) showed attenuation of the corticomedullary differentiation, 47 (30.9%) kidneys showed either renal cysts or dystrophic calcification or both. 28 kidneys (18.4%) had neither attenuated corticomedullary (CMD) differentiation nor raised resistivity index value. CONCLUSION Duplex Doppler provides an easily applicable, non-invasive, and well-established method for investigating renal morphologic characteristics, diagnosing renal artery stenosis, and measuring vascular resistance in the renal parenchyma. The resistive index measured by duplex Doppler is used as an indicator of underlying renal pathology and progression of the disease.
Authors and Affiliations
Rajiv Kumar, Mozammil Hassan, Raunak Deo, Kousik Mandal, Kumar Abhinav
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