Abstract
Type 2 diabetes mellitus (type 2 DM) is one of the common epidemics worldwide. The prevalence of type 2 DM is high among Saudi population. Renal affection by DM is in the form of nephropathy that may end in the end stage of renal disease (ESRD) and renal failure warrants chronic dialysis or renal transplantation. Renal Ultrasonography (US) is a simple, accurate, affordable and non-invasive test that can help in management of type 2 DM patients who have renal affection. Four hundred patients, aged from 13 - 93 years with type 2 DM were recruited from the outpatient internal and family medicine clinics at KAUH. Renal US was requested for 202 patients, and was done at the diagnostic radiology department using digital iU22 Philips machine with 3.5 - 5 MHz convex array transducer. The renal size, parenchymal echogenicity and associated renal pathologies e.g. stones, cysts or masses were evaluated. Statistical analysis was performed using SPSS program version 16. Most cases showed normal renal size and echogenicity. Grade one nephropathy was more than grade two or three. Nephropathy was non-significantly correlated to the patients’ gender, but to their age. Increased patients’ age was associated with increased renal echogenicity. Non-diabetes-related renal abnormalities were detected in 39% of patients. The most common of non-diabetes-related renal abnormalities was simple renal cyst followed by renal stones (25% and 23%) respectively. Renal US for patients with type 2 DM has a great role in diagnosing and grading diabetic nephropathy, selecting cases with non-diabetic nephropathy for renal biopsy, and detecting associated renal abnormalities. Due to the high prevalence of DM in Saudi Arabia, we recommend future expanding study of the underlying possible genetic relation between DM and renal cysts and also the relation between renal stones and type 2 DM.
Highlights
Ultrasound has been routinely used for decades in the diagnosis of different renal diseases owing to its great advantages i.e. being non-invasive, reliable, widely available, and affordable
Females were more affected than males (59%:41%) respectively. renal Ultrasound was requested for 50.5% of the patients
Regarding the renal parenchymal echogenicity, we found that most cases showed normal echogenicity (87.6% on the right side and 88.1% on the left side), while grade 1 nephropathy was more common than grade or 3 “Figures 1(a) and (b)”
Summary
Ultrasound has been routinely used for decades in the diagnosis of different renal diseases owing to its great advantages i.e. being non-invasive, reliable, widely available, and affordable. The kidney is always affected in the course of diabetes mellitus (DM), yet Type 2 diabetes has a more variable course. Patients often present at diagnosis with microalbuminuria due to delays in diagnosis and other factors affecting protein excretion. Some patients with microalbuminuria may suffer from renal complications. Reluctance in treatment, may lead overt nephropathy in about 30% of patients and, after 20 years of nephropathy, approximately 20% develop ESRD (end stage renal disease) [1]. The prevalence of DM in the Saudi population is high and 90% of diabetic have
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