Abstract

Chronic kidney disease (CKD) of unknown etiology is recognized as a major public health challenge and a leading cause of morbidity and mortality in the dry zone in Sri Lanka. CKD is asymptomatic and are diagnosed only in late stages. Evidence points to strong correlation between progression of CKD and kidney fibrosis. Several biochemical markers of renal fibrosis have been associated with progression of CKD. However, no marker is able to predict CKD consistently and accurately before being detected with traditional clinical tests (serum creatinine, and cystatin C, urine albumin or protein, and ultrasound scanning). In this paper, we hypothesize that fibrosis in the kidney, and therefore the severity of the disease, is reflected in the frequency spectrum of the scattered ultrasound from the kidney. We present a design of a simple ultrasound system, and a set of clinical and laboratory studies to identify spectral characteristics of the scattered ultrasound wave from the kidney that correlates with CKD. We believe that spectral parameters identified in these studies can be used to detect and stratify CKD at an earlier stage than what is possible with current markers of CKD.

Highlights

  • Chronic kidney disease (CKD) is a major public health challenge and a leading cause of morbidity and mortality1

  • No specific treatment has shown to arrest the progression of CKD, except dialysis or kidney transplantation1

  • New variety of CKD has been identified among paddy farmers (known as CKD of unknown etiology (CKDu) or Chronic Interstitial Nephropathy among Agricultural Communities (CINAC)) in the North Central Province of Sri Lanka7

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Summary

11 Apr 2018 report report

Università di Padova, Any reports and responses or comments on the article can be found at the end of the article. Keywords Chronic Kidney Disease of unknown etiology, Ultrasound spectral characteristics, Kidney fibrosis. We agree with the reviewer’s concerns with regards to the sensitivity analysis and have added this information to the ‘Proposed ex vivo experiment’ section. We have stated that all clinical results will be normalized to anthropometric features such as body height etc. As highlighted by Lucisano et al, 2015 We have stated that all clinical results will be normalized to anthropometric features such as body height etc. as highlighted by Lucisano et al, 2015

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