Department of Internal Medicine, Faculty of Medicine, Biruni University, Istanbul, Turkey.
Department of Nephrology, Istanbul Training and Research Hospital, Istanbul, Turkey.
Ren Fail. 2022 Dec;44(1):314-319. doi: 10.1080/0886022X.2022.2035763.
Kidney interstitial fibrosis is an important risk factor for the progression of chronic kidney disease. Kidney elastography is a noninvasive imaging modality that might be used to assess tissue fibrosis. In this study, we aimed to investigate the relationship between tissue stiffness detected in kidney elastography and interstitial fibrosis observed in kidney biopsy.
Patients who were hospitalized in a tertiary care university hospital with a kidney biopsy indication were included in this study. In all patients, the transverse and sagittal elastography measurements were made using a sonoelastography device before the biopsy. The total histological score was calculated.
Fifty-seven native kidney patients with proteinuria were included in the study. Patients were divided into two groups according to the presence ( = 6) and absence of fibrosis ( = 51) as detected by kidney biopsy. A significant correlation was found between the presence of fibrosis detected by biopsy and elastography outcomes ( = .046, = .192). A significant correlation was found between the urea and creatinine levels and transverse elastography measurements ( = .036, = .240). No correlation was observed between the transverse elastography measurements and total histological score consisting of glomerular, vascular, and tubular scores ( = .006, = .967).
The findings of our study suggest a significant relationship between the elastography measurements and interstitial fibrosis. Because of the high negative predictive value (91%), we suggest that elastography should mainly be used as an exclusion test for the presence of fibrosis. We also believe that elastography may be useful to evaluate the fibrosis status in kidney diseases.
肾间质纤维化是慢性肾脏病进展的重要危险因素。肾脏弹性成像是一种非侵入性的成像方式，可用于评估组织纤维化。本研究旨在探讨肾脏弹性成像中检测到的组织硬度与肾脏活检中观察到的间质纤维化之间的关系。
本研究纳入了因肾脏活检指征而住院的三级保健大学医院的患者。在所有患者中，在活检前使用超声弹性成像设备进行了横向和矢状弹性测量。计算了总组织学评分。
本研究纳入了 57 例有蛋白尿的原肾患者。根据活检是否存在纤维化（ = 6）和不存在纤维化（ = 51）将患者分为两组。活检检测到的纤维化存在与弹性成像结果之间存在显著相关性（ = .046， = .192）。尿素和肌酐水平与横向弹性测量之间存在显著相关性（ = .036， = .240）。横向弹性测量与肾小球、血管和管状评分组成的总组织学评分之间无相关性（ = .006， = .967）。
本研究结果表明弹性成像测量值与间质纤维化之间存在显著关系。由于高阴性预测值（91%），我们建议弹性成像主要用作纤维化存在的排除性检测。我们还认为弹性成像可能有助于评估肾脏疾病中的纤维化状态。
