Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
Clin Exp Nephrol. 2021 Sep;25(9):981-987. doi: 10.1007/s10157-021-02063-2. Epub 2021 May 8.
The progression of chronic kidney disease (CKD) depends on the extent of fibrosis in the kidneys; however, a renal biopsy is necessary to evaluate the severity of renal fibrosis. Real-time tissue elastography (RTE), which measures heartbeat-induced tissue displacement, can assess the elasticity of organs. Here, we aimed to investigate the correlation between renal elasticity and the extent of fibrosis in renal biopsy samples.
We investigated 29 consecutive patients who underwent a renal biopsy at Ehime University Hospital from February 2018 to August 2019. Renal fibrosis was categorized into three grades, mild (< 25%), moderate (25-50%), and severe (> 50%), based on the total affected area within the biopsy sample. The association between renal elasticity assessed by RTE and the grade of renal fibrosis was evaluated, and a receiver operating characteristic curve was used to distinguish the severity of renal fibrosis.
The mean age and estimated glomerular filtration rate (eGFR) were 58.8 years and 55.2 mL/min/1.73 m, respectively. The median urine protein-to-creatinine ratio was 1.24 g/gCr. The mean renal elasticity of mild, moderate, and severe renal fibrosis was 3.40, 3.98, and 4.77, respectively. Renal elasticity of native kidneys was significantly positively correlated with the grade of renal fibrosis (ρ = 0.529, P = 0.003). At the cutoff point of 3.81, the area under the curve, sensitivity, and specificity were 0.778, 68.4%, and 81.8%, respectively.
Real-time tissue elastography is a promising, non-invasive method for assessing renal fibrosis in patients with CKD.
慢性肾脏病（CKD）的进展取决于肾脏纤维化的程度；然而，评估肾纤维化的严重程度需要进行肾活检。实时组织弹性成像（RTE）测量心跳引起的组织位移，可以评估器官的弹性。在这里，我们旨在研究肾弹性与肾活检样本中纤维化程度之间的相关性。
我们调查了 2018 年 2 月至 2019 年 8 月在爱媛大学医院接受肾活检的 29 例连续患者。根据活检样本中总受累面积，将肾纤维化分为轻度（<25%）、中度（25-50%）和重度（>50%）。评估 RTE 评估的肾弹性与肾纤维化程度之间的相关性，并使用受试者工作特征曲线来区分肾纤维化的严重程度。
平均年龄和估计肾小球滤过率（eGFR）分别为 58.8 岁和 55.2 mL/min/1.73 m。尿蛋白与肌酐比的中位数为 1.24 g/gCr。轻度、中度和重度肾纤维化的平均肾弹性分别为 3.40、3.98 和 4.77。固有肾脏的肾弹性与肾纤维化程度呈显著正相关（ρ=0.529，P=0.003）。在 3.81 的截断点处，曲线下面积、灵敏度和特异性分别为 0.778、68.4%和 81.8%。
实时组织弹性成像（RTE）是一种有前途的、非侵入性的评估 CKD 患者肾纤维化的方法。
