Early evaluation of renal hemodynamic alterations in type I diabetes mellitus with duplex ultrasound

• Main Authors: Saif Aasem, Soliman Neveen, Abdel-Hameed Alaa
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2010-01-01
• Series: Saudi Journal of Kidney Diseases and Transplantation
• Online Access: http://www.sjkdt.org/article.asp?issn=1319-2442;year=2010;volume=21;issue=2;spage=295;epage=299;aulast=Saif

To evaluate the role of renal duplex ultrasonography in the detection of early alte-ration of renal blood flow in type I diabetic patients, we studied with duplex ultrasound 32 patients with type I diabetes mellitus (19 males, 13 females, age range 8-19 years) and 35 age and sex-matched controls. The resistivity indices (RIs) and pulsatility indices (PIs) of the main renal as well as intra-renal arteries were calculated. Compared with the healthy control subjects, diabetic patients had significantly higher resistivity indices (RIs) in the intrarenal (segmental, arcuate and interlobar) ar-teries (P= 0.001). The study, also revealed a significantly positive correlation between the RIs in the intrarenal arteries in diabetics and the albumin/creatinine ratio (r= 0.54, 0.52 and 0.51 respectively), glycated hemoglobin (r= 0.61, 0.59 and 0.63 respectively), as well as the estimated GFR (e-GFR) (r= 0.53, 0.51 and 0.57 respectively). We conclude that the current study documented early intra-renal hemodynamic alterations in the form of pathologically elevated intrarenal RIs. This denotes the potential usefulness of duplex evaluation of the intrarenal arteries, as a noninvasive procedure, for monitoring type 1 diabetic patients to predict those at risk of diabetic nephropathy.