Analysis of Ultrasound as a Predictor of Renal Impairment in Patients with HCV Infection

Abstract

Background: Renal arterial waveform analysis done via renal Duplex Doppler Ultrasound gives a safe, trustworthy, and real time assessment of renal hemodynamics without any delay and ambiguity as it removes various components that make estimation of renal function problematic. Objective: To evaluate the clinical validity of RI and to identify the relationship between RI and RFT’s for evaluation of renal function in patient. Analytical cross sectional examination was done at DHQ teaching hospital Sargodha from 2020 to 2021. The it had 158 hepatitis C positive patients and 79 healthy volunteers following approval of summary. After validation of inclusion and exclusion criteria, patients were broken in into 4 groups (A to D) according to stage of disease and controls were kept in Group E. Grey scale ultrasonography test for renal measurements and renal echogenicity was done. Sagittal and axial scans was done in supine posture from anterior approach utilizing liver and spleen as an acoustic window. The size and texture of liver was also assessed. Color Doppler was done to calculate Resistive Index (RI) using conventional curvilinear probe. Results: The serum creatinine and urea levels in the diseased groups were greater than those in the control group. It was individuals in Group-D who had the highest creatinine levels, which were followed by those in Groups C, B, and A, respectively. The greatest Urea level was found in Group-D, at 49.6714.19, while the lowest was found in Group-A. The mean RI in sick groups (the highest was in Group D, with values of 0.78 and 0.81 in the right and left kidneys, respectively) was similarly statistically substantially greater. Conclusion: An important connection exists between RI and RFT. The use of Doppler duplex ultrasonography for the study of renal hemodynamics in cirrhotic patients with HCV is a reliable, non-invasive, simple, immediate, and cost-effective method for examining renal hemodynamics in these patients. It is not essential to have clinical symptoms or deviations from RFTs for this test to be more accurate than RFTs at predicting disease development. Keywords: Renal Doppler Duplex Ultrasound, Renal Resistive Index (RI), Renal function tests, Urea, Creatinine, Cirrhosis, HCV