Kodikara Iroshani, Gamage Dhanusha T K, Nanayakkara Ganananda, Ilayperuma Isurani
Department of Anatomy, Faculty of Medicine, University of Ruhuna, Galle80000, Sri Lanka.
Base Hospital Tissamaharama, Tissamaharama, Debarawewa82600, Sri Lanka.
Asian Biomed (Res Rev News). 2020 Oct 31;14(5):195-202. doi: 10.1515/abm-2020-0028. eCollection 2020 Oct.
Association between early diagnosis of chronic kidney disease (CKD) and low morbidity and mortality rate has been proven. Thus, tools for early CKD diagnosis are vital. Ultrasonography has been widely used to diagnose and monitor the progression of CKD.
To determine the performance of selected renal ultrasonographic parameters for the diagnosis of early CKD.
In a cohort of patients diagnosed with CKD (n = 100), diagnostic performance of ultrasonographically measured renal length (RL), renal cortical thickness (RCT), and parenchymal thickness (PT) was determined using receiver operating curve analysis; correlation of each parameter with the associated comorbidities and serum creatinine (Scr) levels was also determined. Severity of CKD was graded with estimated glomerular filtration rates (eGFR).
Of all patient participants, 85 had severity grades 2 or 3. Mean (standard deviation) Scr was 1.88 (0.60) mg/dL; eGFR was 43.3 (11.85) mL/min/1.73 m. RL was 9.01 (0.83) cm, PT was 1.32 (0.22) cm, and RCT was 6.0 (0.10) mm. PT and RCT were positively correlated with eGFR ( = 0.01 and 0.002, respectively). Early CKD was better predicted by PT (area under the curve (AUC) 0.735; 82% sensitivity; 30% specificity; 68% positive predictive value (PPV)) and RCT (AUC 0.741; 82% sensitivity; 48% specificity; 51% PPV); severe CKD was better predicted by RL (AUC 0.809; 67% sensitivity; 26% specificity, 45% PPV; 13% negative predictive value).
Index ultrasonic parameters show a diagnostic role in different stages of CKD. The index ultrasound and biochemical parameters showed a complementary role in predicting renal dysfunction.
慢性肾脏病（CKD）的早期诊断与低发病率和死亡率之间的关联已得到证实。因此，早期CKD诊断工具至关重要。超声检查已被广泛用于诊断和监测CKD的进展。
确定所选肾脏超声参数对早期CKD的诊断性能。
在一组确诊为CKD的患者（n = 100）中，使用受试者工作特征曲线分析确定超声测量的肾脏长度（RL）、肾皮质厚度（RCT）和实质厚度（PT）的诊断性能；还确定了每个参数与相关合并症和血清肌酐（Scr）水平的相关性。CKD的严重程度用估计肾小球滤过率（eGFR）分级。
在所有参与患者中，85例为2级或3级严重程度。平均（标准差）Scr为1.88（0.60）mg/dL；eGFR为43.3（11.85）mL/min/1.73 m²。RL为9.01（0.83）cm，PT为1.32（0.22）cm，RCT为6.0（0.10）mm。PT和RCT与eGFR呈正相关（分别为r = 0.01和0.002）。PT（曲线下面积（AUC）0.735；灵敏度82%；特异性30%；阳性预测值（PPV）68%）和RCT（AUC 0.741；灵敏度82%；特异性48%；PPV 51%）对早期CKD的预测效果较好；RL对重度CKD的预测效果较好（AUC 0.809；灵敏度67%；特异性26%；PPV 45%；阴性预测值13%）。
超声指标参数在CKD的不同阶段显示出诊断作用。超声指标和生化参数在预测肾功能不全方面显示出互补作用。
