Comparison of renal resistive index among patients with Type 2 diabetes with different levels of creatinine clearance and urinary albumin excretion

Abstract

To evaluate the prevalence of increased renal resistive index and related factors among patients with Type 2 diabetes with different levels of creatinine clearance and urinary albumin excretion. Laboratory analyses, including calculation of 24-h urinary albumin excretion and 24-h creatinine clearance, and renal doppler ultrasonography to measure renal resistive index, were carried out for patients newly diagnosed with Type 2 diabetes mellitus. Participants were classified into four groups according to 24-h creatinine clearance and 24-h urinary albumin excretion levels. Group 1 was composed of 73 patients (54.1%) with normal 24-h creatinine clearance and 24-h urinary albumin excretion. Group 2 was composed of 34 (25.2%) patients with normal 24-h creatinine clearance and increased 24-h urinary albumin excretion. Group 3 was composed of 14 (10.4%) patients with decreased 24-h creatinine clearance and normal 24-h urinary albumin excretion. Group 4 was composed of 14 (10.4%) patients with both decreased 24-h creatinine clearance and increased 24-h urinary albumin excretion . In total, 41 patients (30.4%) had increased renal resistive index levels. Comparison of the four groups with respect to increased renal resistive index revealed: among group 1 patients, 10 (13.7%) had increased renal resistive index levels; among group 2 patients, 14 (41.2%) had increased renal resistive index levels; among group 3 patients, eight (57.1%) had increased renal resistive index levels; among group 4 patients, nine (64.3%) had increased renal resistive index levels (P<0.0001 for trend). In multivariate regression, 24-h creatinine clearance (P<0.0001), but not 24-h urinary albumin excretion, was related to increased renal resistive index levels. Renal resistive index levels were highest in patients with Type 2 diabetes with both decreased 24-h creatinine clearance and increased 24-h urinary albumin excretion, whereas they were lowest in patients with normal creatinine clearance and normal urinary albumin excretion.