Abstract
The early detection of a kidney injury is essential to protect against the progression of kidney damage owing to the progressive nature of chronic kidney disease. A renal biopsy is the gold standard for the assessment of pathological alterations such as interstitial fibrosis and glomerulosclerosis. However, there are concerns regarding potential complications including bleeding and a reduction in renal function. Ultrasound elastography is an ideal modality for assessing the alterations in various organs and diagnosing malignant tumors. This technique has the potential to help detect early changes in renal function and pathological alterations. However, the careful application and interpretation of this technique in the kidney is required because of its complex hemodynamics and architecture. Shear wave elastography is the most widely investigated technique among ultrasound elastography. This review aims to summarize the previous investigations of the kidney using shear wave elastography, particularly for renal malignancy, kidney transplantation, and chronic kidney disease. Additionally, we have highlighted the influencing factors concerning the practical measurement of renal elasticity.
Highlights
IntroductionThe number of patients with chronic kidney disease (CKD) is increasing worldwide [1]
The number of patients with chronic kidney disease (CKD) is increasing worldwide [1].CKD is a risk factor for cardiovascular disease and the incidence rate of cardiovascular events increases with the progression of CKD [2]
Ultrasound elastography is widely applied to CKD in native and transplanted kidneys
Summary
The number of patients with chronic kidney disease (CKD) is increasing worldwide [1]. Because the kidney has a compensatory mechanism in response to nephron loss, serum creatinine or urinary protein levels are not accurate indices for detecting early changes in CKD patients. Another issue requiring improvement in the clinical practice in patients with CKD is that renal pathological changes such as glomerulosclerosis, tubular atrophy, and interstitial fibrosis can be assessed only by a renal biopsy. As there is no established method for assessing pathological changes without a renal biopsy, it has been clinically challenging to detect early changes in kidney injuries and to non-invasively assess the pathological changes. For a better understanding of this technique, we have reviewed and summarized the clinical evidence for renal ultrasound elastography and the technical aspects necessary for its practical application
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