FC013: Shear Wave Elastography Effective in Ultrasound Diagnosis of Chronic Kidney Disease in Patients With hyperuricaemia And Gout

Abstract

Abstract BACKGROUND AND AIMS Shear wave elastography (SWE) is a well-known ultrasound method for assessing liver, yet has a limited use in nephrology. Gout is associated with risk of chronic kidney disease (CKD, nephropathy) progression. Ultrasonography (US) can provide accurate information for detecting kidney disease in gout (Bubnov and Melnyk. Evaluation of biomarkers for diagnostic decision making in patients with gout using novel mathematical model. Complex PPPM approach. EPMA J. 2014;5(Suppl 1): A58. doi:10.1186/1878-5085-5-S1-A58) and can help monitoring treatment effect (Short-term probiotics regimen may help treat gout, kidney disease. Personalized medicine approach may improve signs of metabolic syndrome. American Physiological Society (APS) News Room, 03.10.2019 https://www.the-aps.org/detail/news/2019/10/04/short-term-probiotics-regimen-may-help-treat-gout-kidney-disease?SSO=Y). The aim was to study the added diagnostic value of SWE effective in ultrasound diagnosis of CKD in patients with hyperuricaemia and gout. The aim was also to study the relevance of US markers of kidney including SWE and B-flow to provide advantages to grey scale and Doppler in assessing kidney disease in gout. METHOD We included 43 patients (38–75 years; 15 women) with gout/increased levels of uric acid in blood, gout attacks according to disease history. The control group included 38 healthy individuals (20 women), mean age 44 ± 8 years without clinical, laboratory signs of nephropathy and liver pathology. All patients underwent general clinical, lab tests; abdominal US including precise multiparameter US of kidneys measuring SWE, and B-flow in parenchyma and vessels were conducted using curved abdominal transducer of LOGIQ 9 systems (GE Healthcare). RESULTS CKD signs included thinning, increasing echogenicity of kidney parenchyma (P < 0.05), detection of fibrotic changes and small hyperechoic inclusions, hilly margins, anechoic strips under the capsule, RI increasing in segmental arteries over 0.7. The SWE change was 8.7 ± 1.5 (6–13 kPa) versus 4.5 ± 1.2 kPa (P < 0.05). High spatial resolution of B-flow imaging helped to display complex perfusion, pyramids structure, detect vascular flow in areas of heterogeneity on grey scale and evaluate arcuate arteries. We detected signs of fatty liver in all patients (LF2–4); liver size in the right lobe was 170 ± 7 versus 142 ± 8 mm in controls; liver size and SWE data demonstrated positive correlation with kidney SWE. CONCLUSION SWE is and effective and accessible complementary technique capable of providing added diagnostic value to assess the kidney parenchyma. Multiparameter ultrasound is an effective method for early detection of CKD in patients with hyperuricaemia and gout. Petrifications, deformations parenchyna, blood flow abnormalities and SWE markers are the most reliable ultrasound signs, specific for kidney disease in gout.