Abstract
BackgroundTo explore the potential value of three-dimensional ultrasonography (3DUS) and contrast-enhanced ultrasound (CEUS) in the diagnosis of diabetic nephropathy (DN) in Chinese diabetic patients with kidney injury.MethodsPatients with type 2 diabetes mellitus and kidney injury in our hospital were enrolled, and the clinical characteristics as well as the laboratory data of patients were collected; 3DUS and CEUS were used to evaluate the morphological structure and blood perfusion of kidneys. Eligible patients were categorized into two groups based on renal biopsy results: DN group and non-diabetic renal diseases (NDRD) group. Correlation analysis and logistic regression analysis were applied to identify the risk factors of DN development.ResultsA total of 115 patients aged from 24 to 78 years old were recruited in the experiment, of which 64 patients (55.65%) and 51 patients (44.35%) were in the DN group and NDRD group, respectively. After correction to CKD stage, BMI and right kidney volume index were retained to identify patients with DN. The ROC of the logistic regression model had an AUC of 0.703 (95% CI: 0.591–0.815) and it was higher than both indicators.Conclusion3DUS has potential value in the diagnosis of diabetic nephropathy in Chinese diabetic population with kidney injury and may act as an auxiliary diagnosis for DN. More prospective and well-designed studies with larger samples are needed to verify the result.
Highlights
To explore the potential value of three-dimensional ultrasonography (3DUS) and contrast-enhanced ultrasound (CEUS) in the diagnosis of diabetic nephropathy (DN) in Chinese diabetic patients with kidney injury
General characteristics One hundred forty-six cases in total with diabetes and kidney injury were preliminary included, and 31 cases were excluded due to the following reasons: pathological biopsy indicating the comorbidity of DN and non-diabetic renal diseases (NDRD) (n = 9); renal biopsy was not performed (n = 6); no contrast-enhanced ultrasound was performed (n = 12); patients with unilateral or bilateral renal artery stenosis (n = 4)
There were no significant differences between the DN group and the NDRD group in age distribution, gender distribution, body surface area and diastolic blood pressure (DBP) (p > 0.05)
Summary
To explore the potential value of three-dimensional ultrasonography (3DUS) and contrast-enhanced ultrasound (CEUS) in the diagnosis of diabetic nephropathy (DN) in Chinese diabetic patients with kidney injury. Diabetes mellitus is one of the most common metabolic diseases in the world. Diabetic nephropathy (DN) is one of the most common and important complications of diabetes. In. Li et al BMC Nephrology (2020) 21:243 addition, NDRD has a relatively better prognosis since it is usually treatable and even curable, whereas the renal lesions in DN are believed to be more irreversible [3]. Renal biopsy is considered as the canonical standard to discriminate DN from NDRD [4]. A large proportion of patients with type 2 diabetes mellitus (DM) are not formally evaluated by renal biopsy [5, 6]. DN patients are usually diagnosed based on their clinical symptoms.
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