Department of Ultrasound, Guangdong Provincial Hospital of Chinese Medicine-Zhuhai Hospital, Zhuhai, Guangdong, China.
Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine-Zhuhai Hospital, Zhuhai, Guangdong, China.
Dis Markers. 2022 Oct 5;2022:4231535. doi: 10.1155/2022/4231535. eCollection 2022.
Diabetic kidney disease (DKD) has been well recognized as a microvascular complication of diabetes mellitus. Perfusion of intrarenal arteries is closely related with development of DKD. The aim of the present study was to investigate relation of ultrasonography performance of intrarenal arteries and grade of DKD.
From May to December at 2021, a total of 54 DKD patients and 36 non-DKD cases were recruited. Ultrasonography performance of intrarenal and arteries at lower extremity was examined by high-resolution ultrasound diagnostic equipment; maximum (Vsmax) as well as minimum (Vdmin) blood velocity of arteries were recorded, and resistance index (RI) of arteries were calculated. Blood routine and biochemical parameters were determined from clinical laboratory of our hospital.
According to eGFR grading, 42.50% of the 54 DKD cases are at Grade 1, and 18.52%, 11.11%, 9.26%, and 18.52% cases were at Grade 2, 3a, 3b, and 4-5, respectively. Blood urea and creatinine were significantly positively related with progress of DKD, while level of Hb was negatively related with DKD. By ultrasonography; we found that Vsmax and Vdmin of main renal artery (MRA), segmental renal artery (SRA), and interlobular renal artery (IRA) were significantly reduced compared with healthy cases; IR of the above arteries was dramatically elevated, and changes of the above data were more obvious than that of lower extremity. Vdmin of MRA, SRA, and IRA was negatively related with grading of DKD, while RI was positively related with the grading. Converging from RI and level of Hb, we found that the level of Hb is positively related with healthy status of the kidney, while RI of the arteries is negatively with that.
Resistance index (RI) of intrarenal arteries, obtained from ultrasonography combining with level of hemoglobin (Hb), is the predictor of progress of DKD.
糖尿病肾病(DKD)已被公认为糖尿病的微血管并发症。肾内动脉的灌注与 DKD 的发展密切相关。本研究旨在探讨肾内动脉的超声表现与 DKD 分级的关系。
2021 年 5 月至 12 月,共纳入 54 例 DKD 患者和 36 例非 DKD 患者。采用高分辨率超声诊断仪检查肾内和下肢动脉的超声表现;记录动脉的最大(Vsmax)和最小(Vdmin)血流速度,并计算动脉的阻力指数(RI)。从我院临床检验科测定血常规和生化参数。
根据 eGFR 分级,54 例 DKD 患者中 42.50%为 1 级,18.52%、11.11%、9.26%和 18.52%分别为 2 级、3a 级、3b 级和 4-5 级。血尿素和肌酐与 DKD 的进展呈显著正相关,而 Hb 水平与 DKD 呈负相关。通过超声检查,我们发现主肾动脉(MRA)、节段肾动脉(SRA)和小叶间肾动脉(IRA)的 Vsmax 和 Vdmin 明显低于健康对照组;上述动脉的 RI 明显升高,且上述数据的变化明显大于下肢动脉。MRA、SRA 和 IRA 的 Vdmin 与 DKD 分级呈负相关,而 RI 与分级呈正相关。从 RI 和 Hb 水平来看,我们发现 Hb 水平与肾脏健康状况呈正相关,而动脉 RI 与肾脏健康状况呈负相关。
超声检查结合血红蛋白(Hb)水平获得的肾内动脉阻力指数(RI)是 DKD 进展的预测指标。