Renal ultrasound findings in chronic kidney disease – a single centre study from Hambantota district of Sri Lanka

Abstract

Background Aetiology of chronic kidney disease (CKD) has shown geographical clustering. Renal ultrasound (USS) is used to diagnose CKD, but USS features are known to vary with aetiology of CKD. Objectives To describe aetiological factors and USS features of CKD. Methods Renal USS was performed in diagnosed adult CKD patients (n=100) and a control group (CG) with normal renal function (n=90). Demographic data, associated comorbidities, serum creatinine values, renal length (RL), renal cortical echogenicity, and number of renal cysts were recorded. CKD severity was graded. Results Hypertension (38%) and diabetes (17%) were commonest aetiological factors of CKD. Severity of CKD was as follows: 35% grade 3a, 39% grade 3b, 11% grade 2, and 15% grade 4. Mean RL of CKD group (9.07cm; SD=0.84) was significantly lower (p<0.001) than the CG (9.83cm; SD=0.79). In CG, the left kidney was longer than the right kidney (T=2.89; P=0.04); but no significant RL difference between both sides in the CKD group (T=0.19; p=0.19). CKD patients (14%) had small kidneys with increased renal cortical echogenicity (95.7%); 55% in sonographic echogenicity grade 2, 20% grade 1, 30% grade 3, 3% normal echogenicity, and 2% grade 4. RL has progressively decreased with CKD severity. Renal cysts were prevalent in CKD group (34%). Compared to diabetics (5.8%), small kidneys were frequently found in hypertensive patients (21.2%). Conclusion Hypertension and diabetes as the commonest aetiological factors of CKD had shown as influence on renal length. Renal length and the echogenicity had varied with the severity of CKD.