Abstract
Glomerulosclerosis and tubulointerstitial fibrosis are associated with lower renal parenchymal elasticity. This study was designed to evaluate the predictive ability of renal elasticity in patients with chronic kidney disease (CKD). 148 non-CKD patients and 227 patients with CKD were recruited. 145 (38.7%) were female, 166 (73.1%) had diabetes, the mean estimated glomerular filtration rate (eGFR) was 33.9 ± 15.8 ml/min/1.73 m2 and the median urinary protein-to-creatinine ratio (UPCR) 502 (122–1491) mg/g. Patients with later stages of CKD had lower renal elasticity values, indicating stiffer kidneys (p < 0.001), and smaller kidney (p < 0.001). Renal elasticity correlated with log-transformed UPCR (β = −7.544, P < 0.001). Renal length correlated with age (β = −0.231, P < 0.001), sex (β = −3.730, P < 0.001), serum albumin level (β = −3.024, P = 0.001), body mass index (β = 0.390, P = 0.009) and eGFR (β = 0.146, P < 0.001). In fully-adjusted logistic regression model, the odds ratio (OR) per 10 unit change in renal elasticity for rapid renal deterioration was 0.928 (95% CI, 0.864–0.997; P = 0.042). The OR per 1 mm change in renal length for rapid renal deterioration was 1.022 (95% CI, 0.994–1.050; P = 0.125). Renal elasticity is associated with proteinuria and rapid renal deterioration in patients with CKD.
Highlights
While pathological findings of glomerulosclerosis and tubulointerstitial fibrosis obtained through biopsies have been associated with worse outcomes in renal diseases[5,6,7], many noninvasive methods, including serum and urinary biomarker measurements and renal image studies, have been used to assess these renal injuries in humans[8,9,10]
They include transient elastography (TE), acoustic radiation force impulse imaging (ARFI) and shear wave elastography (SWE), which measure the speed of the shear wave generated by an acoustic pulse or a vibration through the tissue, as well as real-time elastography (RTE), which assesses elasticity based on the physical strain within the tissue created by external compression[12,13,14,15]
We found a significant association between rapid renal deterioration and renal elasticity (p = 0.042) but not renal length(p = 0.125) in patients with Chronic kidney disease (CKD) Stages 3–5 assessed by traditional sonography
Summary
While pathological findings of glomerulosclerosis and tubulointerstitial fibrosis obtained through biopsies have been associated with worse outcomes in renal diseases[5,6,7], many noninvasive methods, including serum and urinary biomarker measurements and renal image studies, have been used to assess these renal injuries in humans[8,9,10]. Several imaging techniques have been used to assess the degree of renal damage in patients with different kidney diseases. They include transient elastography (TE), acoustic radiation force impulse imaging (ARFI) and shear wave elastography (SWE), which measure the speed of the shear wave generated by an acoustic pulse or a vibration through the tissue, as well as real-time elastography (RTE), which assesses elasticity based on the physical strain within the tissue created by external compression[12,13,14,15]. There are very few studies investigating the use of RTE to evaluate kidney status in patients with CKD and its predictive value. Changes in kidney function (EGFR) were followed for six months
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