Abstract
BackgroundEvaluation of renal microstructure is pivotal for diagnosing and monitoring chronic renal disease. DWI has been proved to be practicable and reliable examination for the assessment of renal function and parenchymal damage in some renal diseases. Our aim is to appraise DWI sequence and ADC measurement as a potential tool of renal function assessment as well as establishing a possible relationship between the different CKD stages and the renal parenchymal ADC values changes.ResultsRegarding the cause of CKD, nine patients (45%) had glomerulonephritis, 5 patients (25%) had hemolytic uremic syndrome, 2 patients (10%) had lupus nephritis, 2 patients (10%) had nepheronophthisis, and 1 patient (1.5%) had infantile nepherosis, whereas the cause of CKD was unknown in 1 patient (1.5%).The stages of CKD were classified according to KIDGO guidelines: 6 patients (30%) were stage 1, 4 patients (20%) were stage 2, 3 patients (15%) were stage 3, 2 patients (10%) were stage 4, and 5 patients (25%) were stage 5. The patients’ group (group A) had a mean ADC value (1.85 × 10−3 ± 0.24) which was significantly lower than that of the control group (group B) (2.21 × 10−3 ± 0.12). As for the correlation between stage of CKD and ADC, we found it to be a moderate negative one with r’ value of − .655 and a significant p value of < 0.001.ConclusionDWI is recognized as a promising imaging tool that can take part in the assessment of the morphological and functional changes in diffuse renal parenchymal disease, hence playing an important role in the early diagnosis and staging of chronic kidney disease.
Highlights
Evaluation of renal microstructure is pivotal for diagnosing and monitoring chronic renal disease
Ultrasonography and Color Doppler examination Renal ultrasound and Doppler examination were performed for all patients, using an S-6 General Electric (USA) ultrasound device equipped with 5-12 MHz high frequency transducer
The study population was classified into two groups: Group A: Chronic kidney disease (CKD) due to any renal parenchymal disease (40 kidneys) and group B: Healthy control subjects (20 kidneys)
Summary
Evaluation of renal microstructure is pivotal for diagnosing and monitoring chronic renal disease. Relatively infrequent in the pediatric age group, it can be a devastating illness with numerous life-long consequences [1] Serum markers such as blood urea nitrogen level, creatinine, and estimated glomerular filtration rate (eGFR) are useful parameters for estimating renal function [2]; the blood tests depend on age and body mass index; it cannot be used to evaluate a single kidney function [3]. Because of the limitations of serum markers, nowadays, imaging modalities have gained importance in the Diffusion-weighted imaging (DWI) is a technique used to display and measure the diffusion of water molecule It reflects the Brownian motion of water molecules in the tissues [6]. The diffusion characteristics of the kidney may provide information on the mechanism of different renal pathology, like renal parenchymal disease, renal scarring, obstructive uropathy, and chronic renal failure [7]
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