Abstract
To evaluate the diagnostic value of real-time shear wave elastography (SWE) in children with chronic kidney disease (CKD). Children with CKD diagnosed by the ultrasound-guided biopsy between January 2018 and May 2019 were enrolled as the case group. Age- and sex- matched healthy children were selected as the control group. The Young's Modulus (YM) of the renal cortex was measured by SWE after the traditional ultrasound examination. Variance analysis was performed to compare the values of YM between the two groups. Receiver operating characteristic curve (ROC) analysis was used to compare the values of YM, and explore the cut-offs of the YM. In the case group (n = 60, 45% male, mean age of 9.2 years), the kidney YM modulus on the left side (16.8±4.8 kPa vs. 8.3±2.1 kPa) and the right side (16.0±4.7 kPa vs. 8.3±2.4 kPa) were both higher than the control group (all P values < 0.001). With the progress of CKD, the YM value of the left and right kidneys gradually increased. ROC analysis showed that when the left and right kidney YM value was 11.7 kPa and 11.0 kPa, the diagnostic sensitivity and specificity were the highest (left: respectively 93.3% and 95.0%; right: respectively 93.3 % and 91.7%). The increase of YM in CKD is related to the progression of renal dysfunction which may provide a new method for early diagnosis of CKD, dynamic monitoring of disease progression, and evaluation of curative effect and prognosis.
Highlights
Chronic kidney disease (CKD) has become an important public health problem in China[1]
The increase of Young’s Modulus (YM) in chronic kidney disease (CKD) is related to the progression of renal dysfunction which may provide a new method for early diagnosis of CKD, dynamic monitoring of disease progression, and evaluation of curative effect and prognosis
With the increase of IgA nephropathy grade, YM values of both left and right kidneys showed an increasing trend (P< 0.001); The 14 cases (23.3%) of Henoch Schonlein purpura nephritis were classified by International Study of Kidney Disease in Children (ISKDC), including 3 IIB cases (5%), 10 IIIB cases (16.7%), and 1 IVB case (6.7%)
Summary
Chronic kidney disease (CKD) has become an important public health problem in China[1]. Renal biopsy is the gold standard for the diagnosis of CKD in the traditional examination, it is difficult to be widely used as a clinical general survey or routine means due to its invasive and difficulty to be reused. Traditional ultrasound technologies can only show positive results when the renal function is obviously damaged. Real-time shear wave elastography (SWE) is a kind of safe, effective and reproducible ultrasound technology that does not rely on shear wave generated by external force to measure tissue elasticity. Its diagnostic value has been widely confirmed in thyroid nodule[2], liver[3], breast[4] and other tissues.
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