Renal Parenchymal Echogenicity Research Articles

The value of renal color Doppler ultrasound as an objective tool in the diagnosis of renal affection in SLE patients

BackgroundSystemic lupus erythematosus (SLE) is an autoimmune disease with diverse manifestations, which resembles a clinical challenge to be managed. Lupus nephritis is a life-threatening condition as about 10% of patients develop chronic kidney disease.Aim of the workTo assess the role of resistive index (RI) as a noninvasive parameter in detecting renal affection in SLE patients.ResultsA case–control study included 3 matched groups: 30 patients, 15 SLE with no renal affection, and 15 SLE lupus nephritis patients, who were selected, diagnosed according to ACR criteria 2019 for SLE, beside 15 age- and gender-matched healthy controls without any risk factors of chronic diseases. Written informed consent was obtained from all the three groups, and the study was approved by ethical committee. There was a statistically significant increase in both SLEDAI and renal SLEDAI scores, serum BUN, creatinine, urinary pus cells, RBCs, casts and proteins, 24-h urinary proteins, and protein/creatinine ratio beside a statistically significant increase in both right and left resistive indices in the group of lupus nephritis than the other group. There was highly statistically significant difference between SLE without nephritis and SLE with nephritis regarding renal echogenicity. There was statistically significant positive correlation between average RI and SLEDAI, rSLEDAI, serum creatinine, BUN, 24-h urinary proteins, protein/creatinine ratio, and renal echogenicity. Relation between renal echogenicity and demographic, laboratory, and clinical data was highly statistically significant with rSLEDAI, serum creatinine, BUN, 24-h urinary proteins, and P/C ratio. Our study highlighted that the best cutoff point of Rt average RI to detect SLE with nephritis group was found > 0.68 with sensitivity of 86.7% and specificity of 100.0%, while the best cutoff point of left average RI to detect SLE with nephritis group was found > 0.7 with sensitivity of 80.0% and specificity of 100.0%.ConclusionRenal RI is a noninvasive technique that can be used for detection renal disease activity in SLE patients, together with renal parenchymal echogenicity by grayscale US.

A Comparative Study of Renal Parenchymal Resistive Index, Ultrasonographic Grading of Renal Parenchymal Echogenicity, Kidney Length, and Estimated Glomerular Filtration Rate Among Chronic Kidney Disease Patients Undergoing Whole Abdominal Ultrasound at West Visayas State University Medical Center

A Comparative Study of Renal Parenchymal Resistive Index, Ultrasonographic Grading of Renal Parenchymal Echogenicity, Kidney Length, and Estimated Glomerular Filtration Rate Among Chronic Kidney Disease Patients Undergoing Whole Abdominal Ultrasound at West Visayas State University Medical Center

Sonographic appearances of the kidneys and correlation with CD4 count and viral load in adult HIV/AIDS patients in a rural-based infectious disease hospital in sub-saharan Africa

Background: The management of HIV infection is often challenging as it can affect every organ in the body including the kidneys. Determination of the Resistivity Indices (RI) of the intra-renal arteries is an emerging non-invasive tool that could predict renal disease. Aims & objectives: To determine the renal volume, parenchymal pattern, as well as the RI of the intra-renal arteries by Doppler ultrasonography in adult HIV/AIDS patients and correlate findings with CD4 count, viral load and serum creatinine. Materials & methods: This is a comparative cross-sectional descriptive study that involved sonographic assessment of the renal dimensions, parenchymal echogenicity, and Doppler velocimetry of the segmental intra-renal arteries in 100 apparently healthy confirmed HIV-seronegative control subjects and an equal number of confirmed HIV-seropositive adult patients at Retroviral (RV) clinic of our hospital. A Doppler ultrasound machine with a 3.5MHz Curvilinear probe was used. Data analysis: Data obtained was analyzed and presented as means which were compared using Student’s t - test, and p values < 0.05 at 95% intervals were considered significant. Pearson’s correlation coefficient was used to assess correlation. Results: The renal volumes were larger in the HIV/AIDS subjects (right: 125.94 ± 34.02 cm3 and left: 138.99 ± 33.29cm3) than in controls (p = < 0.01) with the left also larger than the right in both HIV/AIDS and control subjects (p = < 0.01, < 0.01) respectively. There were significantly more individuals with abnormal renal echogenicity in the HIV/AIDS subjects than in the controls. The RI was significantly greater in the HIV/AIDS than in control subjects. Both renal volumes showed a weak negative correlation with CD4, viral load, and serum creatinine which was not statistically significant. There was a statistically significant weak negative correlation between renal echogenicity and CD4 but a positive correlation with viral load and serum creatinine. RI showed weak negative correlations with serum creatinine and weak positive correlations with CD4 count. Conclusion: There is a significant difference in renal volume, echogenicity, and RI in HIV/AIDS patients compared to the controls. Renal echogenicity is a better predictor of serum creatinine levels than renal volume and RI. Thus, renal volume and RI do not provide sufficient correlation to be used as a means of monitoring HIV/AIDS patients with renal impairment.

A meta-analysis of pregnancy outcomes in the diagnosis of isolated foetal renal parenchyma by prenatal ultrasonography.

To effectively circumvent foetal structural abnormalities and serious newborn sequelae, antenatal ultrasound evaluation can support making an early diagnosis for potential prenatal management or the termination of pregnancy. This study systematically evaluated a meta-analysis of different pregnancy outcomes in the diagnosis of isolated foetal renal parenchymal echogenicity (IHEK) by prenatal ultrasonography. Two researchers conducted a literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following databases were included in the search: China National Knowledge Infrastructure, Wanfang Medical Network, China Academic Journals Full-text Database, PubMed, Web Of Science and Springer Link; additional library websites were also included, and the search reviewed different pregnancies among patients with IHEK. The outcome indicators were the live birth rate, the incidence of polycystic renal dysplasia and the incidence of pregnancy termination/neonatal death. The meta-analysis was performed using the Stata/SE 12.0 software. A total of 14 studies were included in the meta-analysis (total sample content, 1,115 cases). The combined effect size of prenatal ultrasound diagnosis of pregnancy termination/neonatal mortality in patients with IHEK was 0.289 (confidence interval (CI) 95%; range, 0.102-0.397). The combined effect size of the live birth rate of pregnancy outcomes was 0.742 (CI 95%; range, 0.634-0.850. The combined effect size of the polycystic kidney dysplasia rate was 0.066 (CI 95%; range, 0.030-0.102). The heterogeneity of all three results was > 50%; accordingly, a random-effects model was used. The indications for eugenic labour should not be included in a prenatal ultrasound diagnosis of patients with IHEK. In the results of this meta-analysis, the live birth and polycystic dysplasia rates were optimistic in terms of pregnancy outcomes. Therefore, under the condition of excluding other unfavourable factors, it is necessary to A thorough technical inspection is required to make an accurate judgment.

Posterior Urethral Valve: Factors Affecting the Renal Outcome

Background: Posterior urethral valve (PUV) is the most common cause of lower urinary tract obstruction in male children with associated sequlae. Different factors, such as age at presentation, initial and nadir serum creatinine, renal parenchymal echogenicity on initial USG, vesicoureteric reflux (VUR) , recurrent UTI, bladder dysfunction and the presence or absence of pop-off mechanism like VURD have significant impact on ultimate renal outcome. The main aim of the study was to observe the effects of different prognostic factors like age of presentation and preoperative VUR of the PUV respondents on postoperative long term renal outcome as well as changes of renal function status on the basis of initial and postoperative serum creatinine level in our settings. Material Methods: This was a quasi-experimental study and conducted in the Department of Pediatric urology of Bangladesh Shishu Hospital and Institute, Dhaka. We enrolled 58 male children of different ages having posterior urethral valve, who were admitted in the pediatric urology department from July,2018 to Dec,2021. Results: Total 58 patients included in our study. Among all patients 53.4% were aged between 1 month to 1 year, 39.7% of them were more than 1 year old and 6.9% of them were neonates. Among 31 respondents, 32.3 % had poor renal function 35.5 % of them also had moderately impaired renal function. Again, out of 23 respondents, 30.4% had poor renal function 6% had moderately impaired renal function. The relation between age category and postoperative renal function status (On the basis of postoperative eGFR) of the posterior urethral valve respondents were statistically not significant. Patients who had no VUR, 66.7% of them had normal renal function, 25% had moderately impaired renal function and 8.3% had poor renal function. Respondents who had bilateral VUR, 55% of them had poor renal function and 35% had moderately impaired renal function. Among respondents who had unilateral VUR, 28.6% of them had poor renal function and 28.6% had moderately impaired renal function but 42.9% had normal renal function. The relation between preoperative VCUG findings and postoperative long term renal function status of the PUV patients were statistically significant. 7 (100%) respondents who had preoperative abnormal renal function, more than 71.4% of them had returned to normal renal function after operative procedure. But abnormal renal function was present in 2 (28.6%) patients during follow up. In our study we found 29.3% of our patients had poor renal outcome and 29.3% patients had moderately impaired renal function within the mean follow up period of 19.33±12.38 months (ranges from 9months to 4 years). Conclusion: Our research highlights the significance of age at presentation, despite its statistically negligible effect on long-term renal outcomes. However, among the children with PUV following valve ablation and with a long-term follow-up, beginning serum creatinine and the presence of various types of VUR on initial VCUG had a significant effect (p.05) on postoperative renal function on the basis of serum creatinine.

Fetal Megacystic Spontaneus Resolution: A Case Report

About 1 in 1500 pregnancies have fetal megacystis discovered during the first trimester ultrasound. Because of obstructive or non-obstructive factors, the fetal bladder may appear enlarged. In the first instance, a lower urinary tract obstruction (LUTO) or obstruction of the bladder outlet causes an increase in hydronephrosis, increased renal parenchymal echogenicity, and oligohydramnios beginning in the second trimester. This condition is associated with poor postnatal renal function and high perinatal mortality. Unusual conditions like the megacystis-microcolon-intestinal hypoperistalsis syndrome are uncommon and are among the non-obstructive causes. Megacystis does not always progress as the pregnancy progresses, and earlier research has even documented spontaneous resolution of the condition while pregnant. Prenatal counseling for fetal megacystis is difficult because of the condition's variable etiology, evolution, and prognosis

Ultrasound Renal Score to Predict the Renal Disease Prognosis in Patients with Diabetic Kidney Disease: An Investigative Study.

Renal disease associated with type 2 diabetes mellitus (T2DM) has become the leading cause of chronic kidney disease (CKD). Renal ultrasonography is an imaging examination required in the work-up of renal disease. This study aimed to identify the differences in renal ultrasonographic findings between patients with and without DM, and to evaluate the relationship between renal ultrasound findings and renal prognosis in patients with DM. A total of 252 patients who underwent renal ultrasonography at Chungnam National University Hospital were included. Kidney disease progression was defined as a ≥10% decline in the annual estimated glomerular filtration rate (eGFR), which, in this paper, is referred to as ΔeGFR/year, or the initiation of renal replacement therapy after follow-up. The renal scoring system was evaluated by summing up the following items: the value of renal parenchymal echogenicity (0: normal; 1: mildly increased; and 2: increased) and the shape of the cortical margin (0: normal and 1: irregular; right kidney length/height (RH-0 or 1), mean cortical thickness/renal length/height (CKH-0 or 1), and cortical thickness/parenchymal thickness (CK/PK-0 or 1) based on the median: 0-above median, and 1-below median). Patients with DM had thicker renal PKH than those without, despite having lower eGFRs (0.91 ± 0.15, 0.86 ± 0.14, p = 0.006). In the progression group, the renal scores were significantly higher than those from the non-progression group. In the multivariate logistic regression analysis, the higher renal scores, presence of DM, and younger age were independently predicted for renal disease progression after adjusting for confounding variables, such as the presence of hypertension, serum hemoglobin and albumin levels, and UPCR. In conclusion, patients with high renal scores were significantly associated with renal disease progression. Our results suggest that renal ultrasonography at the time of diagnosis provides useful prognostic information in patients with kidney disease.

Correlation of Increased Renal Parenchymal Echogenicity with Renal Function Tests and Urine Routine Examination in Patients from all over Lahore with low Socio-Economic status

To evaluate the cause of increased renal parenchymal echogenicity in patients coming in our hospital set-up. Materials and Methods: A descriptive study was conducted at Life Hospital, Lahore over a period of fourteen months. A total of 115 patients both male and female, aged 12 to 83 years with the diagnosis of increased renal parenchymal echogenicity were included in the study and patients with normal renal cortical echogenicity were excluded from this study. The study includes different grades of renal parenchymal echogenicity, both males and females of different age groups and correlation with lab findings (Renal Function Tests and Urine R/E). Statistical analysis was conducted in SPSS version 22.0 and Microsoft Excel. Results: Renal parenchymal echogenicity was raised in 55% of males and 44% of females. The most common cause for increased renal parenchymal echogenicity was concluded to be Urinary Tract Infection (UTI)%; (with WBCs seen in 28% of patients, Blood seen in 25% of patients, Leukocytes seen in 23% of patients, RBCs seen in 22% of patients and pus cells seen in 3% of patients). Only 8% of patients were seen with deranged RFTs. Mean age of patients with increased renal parenchymal echogenicity was 32.4 years. Most patients presented with lumbar region pain, burning micturition and dehydration. Conclusion: UTI seems to be the main cause of increased renal parenchymal echogenicity in the patients we studied as majority of the patients did not have a normal urine report. Males were more likely seen with increased renal parenchymal echogenicity. As majority of our patients belonged to poor socio-economic status, so it was concluded that the main cause of UTI could be dehydration due to lack of availability of clean water and poor hygiene conditions.

Sonographic features of radiologically non-functioning kidneys on intravenous urography (IVU) in Kano Metropolis, Nigeria

Background: Despite technological advancement in uro-radiology, renal ultrasonography remains the imaging modality of choice for evaluating various pathological conditions affecting urinary tract (GIT) system.Aim: This study was aimed at evaluating sonographic features of radiologically nonfunctional kidneys in Kano metropolis, Nigeria.Methods: A prospective study involving 94 each of disease and control group were conducted in Kano metropolis from January 2019 to January 2021. Renal scans were performed using a digital ultrasound imaging system; model DP-8800Plus fitted with a 3.5MHz curvilinear transducer. The maximum length, width, and thickness were measured. The renal echogenicity was assessed and graded. Data was analyzed using SPSS Version 22.0Results: The mean values of the right and left renal volumes among adult patients was 400.5 ± 527.3 cm3 and 177.6 ± 174.3 cm3 respectively. For pediatric patients it was 272.3 ± 308.6 cm3 and 241.6 ± 228.7 cm3 for the right and left kidney respectively. The renal parenchymal echogenicity of the right kidney among adult patients were sored as grade II 2 (5.3%), grade III 27 (71%), and grade IV 9 (23.7%), while that pediatric patients were Grade 0 (11.1%), and 8 (88.9%) as grade III. The adults left kidney were scored grade II 2 (6%), and 16 (47%) each as grades III and IV, while the pediatric group scored 3 (25%) as grade II, and 9 (75%) as grade III.Conclusion: Increased renal volume, shrunken kidney, increased renal parenchymal echogenicity, and severe hydronephrosis were strong sonographic indicators of nonfunctional kidneys.

SONOGRAPHIC FEATURES OF RADIOLOGICALLY NON-FUNCTIONING KIDNEYS ON INTRAVENOUS UROGRAPHY (IVU) IN KANO METROPOLIS, NIGERIA

Background: Despite technological advancement in uroradiology, renal ultrasonography remains the imaging modality of choice for evaluating various pathological conditions affecting the urinary tract (GIT) system. Aim: This study was aimed at evaluating sonographic features of radiologically nonfunctional kidneys in Kano metropolis, Nigeria. Methods: A prospective study involving 94 subjects each from the diseased and control groups were conducted in Kano metropolis from January 2019 to January 2021. Renal scans were performed using a digital ultrasound imaging system; model DP-8800Plus fitted with a 3.5MHz curvilinear transducer. The maximum length, width, and thickness were measured. The renal echogenicity was assessed and graded. Data were analyzed using SPSS Version 22.0 Results: The mean values of the right and left renal volumes among adult patients was 400.5 ± 527.3 cm3 and 177.6 ± 174.3 cm3 respectively. For pediatric patients, it was 72.3 ± 308.6 cm3 and 241.6 ± 228.7 cm3 for the right and left kidney respectively. The renal parenchymal echogenicity of the right kidney among adult patients was scored as grade II 2 (5.3%), grade III 27 (71%), and grade IV 9 (23.7%), while those pediatric patients were Grade 0 (11.1%), and 8 (88.9%) as grade III. The adults left kidneys were scored grade II 2 (6%), and 16 (47%) each as grades III and IV, while the pediatric group scored 3 (25%) as grade II, and 9 (75%) as grade III. Conclusion: Increased renal volume, shrunken kidney, increased renal parenchymal echogenicity, and severe hydronephrosis were strong sonographic indicators of nonfunctional kidneys.

Does Delayed Presentation of Posterior Urethral Valve Carry Worse Prognosis?

Posterior urethral valve (PUV) is the most common cause of lower urinary tract obstruction in male neonates, with an incidence of 1 in 8000–25,000 live births. The clinical course of PUV diagnosed late in life is quite unpredictable. The prognosis of late-diagnosed PUV depends chiefly on the renal function at presentation. A literature search was performed on the delayed presentation of PUV. Serum creatinine at presentation, nadir serum creatinine (defined as the lowest creatinine attained in the year after valve ablation), and renal parenchymal echogenicity were significant predictors of final renal outcome. A generalization cannot be made regarding the prognosis of late-presenting PUV patients. The prognosis varies from case to case. If renal function at presentation and after valve ablation is preserved, then late-presenting PUVs carry good prognosis. Age per se does not carry any prognostic significance.

Ultrasonographic chronic kidney disease score and eGFR in the assessment of chronic kidney disease

Objective: A prospective study developed to determine the relationship between the ultrasonographic parameters (kidney length, parenchymal thickness and parenchymal echogenicity obtained from both kidneys) and glomerular filtration rate in patients with Chronic Kidney Disease. Materials and methods: A cross sectional study in 50 patients referred to the department of Radiodiagnosis, Sree Mookambika Institute of Medical Science, Kulasekharam, for ultrasound abdomen with abnormal renal function tests during the period of 12 months (June 2019- June 2020) and who fulfilled the inclusion and exclusion criteria were selected. Both kidneys were evaluated by Siemens ACUSON X300 scanner using a 5.0MHZ wide frequency band, phased assay probe. The US parameters renal length, mean parenchymal thickness and parenchymal echogenicity were evaluated for both right and left kidneys. All three parameters were scored for each kidney and sum of the average scores were used to calculate ultrasonographic CKD score. The eGFR was calculated by using MDRD equation. The correlation between the eGFR and the kidney length, parenchymal thickness, parenchymal echogenicity and ultrasonographic CKD score were made out separately. Results: The mean serum creatinine was 3.9±2.2 and estimated glomerular filtration rate is 22.8±15.1. No patients with eGFR > 90 ml i.e. stage I of kidney disease was studied. The mean renal length in stage V (8.0±1.4), stage IV (8.4±1.0), stage III (9.5±1.3) and stage II (9.8±0.6). The parenchymal thickness in stage V (10.2±3.2), stage IV (10.4±1.8), stage III (13.2±2.6) and stage II (14.2±2.1). The median parenchymal echogenicity in stage V (2.5), stage IV & III (2) and stage II (1). The sonographic CKD score from 4 to 13, stage V (7.9±2.4), stage IV (8.1±1.6), stage III (6.1±1.5) and stage II (5.0±0.7). Conclusion: The ultrasonographic CKD score calculated from the USG parameters such as renal length, parenchymal thickness and parenchymal echogenicity is useful for differentiation of CKD stage 3-5 compared to CKD stage 1-2. We concluded that the ultrasonographic CKD score provide more objective data in the assessment of CKD.

Sonographic Assessment of Kidneys in Human Immunodeficiency Virus Seropositive Patients: A systematic Review

Background: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) remains a major challenge globally, and approximately 180,000 people died from AIDS-related illnesses in Nigeria in 2015. HIV associated nephropathy is the third most common cause of end-stage renal failure.
 Objectives: To review published original research articles on the sonographic evaluation of kidneys in HIV seropositive patients, identifying missing gaps and coming up with an area of further study.
 Methodology: The study was retrospective and a secondary source of data from published original research articles was used. The search was performed through Google search using Google Scholar, EMBASE, PubMed and Medline. All the published original research articles in the English language and the availability of full-text articles were included in the study.
 Results: An electronic search using the search terms had identified 58 related published articles, but only 12 articles were reviewed. This study found out that human immunodeficiency virus-associated nephropathy (HIVAN) to be a most predominant renal disease in HIV positive patients leaving in sub-Saharan Africa with increased renal parenchymal echogenicity and decreased corticomedullary differentiation sonographically, which correlate in raised of serum creatinine level and the degree of patients immune competence (CD4 count). Few studies correlated the sonographic findings with histopathological feature and none uses Doppler ultrasound.
 Conclusion: This study has identified a correlation of the sonographic findings with the histopathological features and the use of Doppler ultrasound as the missing gaps from the previously published research articles in the subject area.

Prenatal Diagnosis and Findings in Ureteropelvic Junction Type Hydronephrosis.

The widespread use of obstetric ultrasonography has increased the detection rate of antenatal hydronephrosis. Although most cases of antenatal hydronephrosis are transient, one third persists and becomes clinically important. Ultrasound has made differential diagnosis possible to some extent. Ureteropelvic junction type hydronephrosis (UPJHN) is one of the most common cause of persistent fetal hydronephrosis and occurs three times more in male fetuses. It is usually sporadic and unilateral. However, when bilateral kidneys are involved and presents with severe hydronephrosis, the prognosis may be poor. Typical ultrasound findings of UPJHN is hydronephrosis without hydroureter. The size and appearance of the fetal bladder is usually normal without thickening of the bladder wall. Several grading systems are developed and increasingly being used to define the severity of prenatal hydronephrosis and provides much more information about prediction of postnatal renal prognosis. If fetal urinary tract dilation is detected; laterality, severity of hydronephrosis, echogenicity of the kidneys, presence of ureter dilation should be assessed. Bladder volume and emptying, sex of the fetus, amniotic fluid volume, and presence of associated malformations should be evaluated. Particularly the ultrasonographic signs of renal dysplasia, such as increased renal parenchymal echogenicity, thinning of the renal cortex, the presence of cortical cysts, and co-existing oligohydramnios should be noticed. Unfortunately, there is no reliable predictor of renal function in UPJHN cases. Unilateral hydronephrosis cases suggesting UPJHN are mostly followed up conservatively. However, the cases with bilateral involvement are still difficult to manage. Timing of delivery is also controversial.

Cryptococcal Pneumonia in a Pediatric Patient with Renal Transplantation

Cryptococcosis is a significant opportunistic infection in solid organ transplant recipients. Patients may have asymptomatic colonization or symptoms of isolated pulmonary disease and severe pneumonia. The disease is diagnosed by culture, direct microscopy or detection of cryptococcal antigen in the body fluid or tissues. We herein present a C. neoformans pneumonia in a renal transplant patient. An 18-year-old male, renal transplanted from his mother, admitted to hospital due to increase in creatinine. On physical examination, there was no finding other than hypertension and operation scar. Urea and creatinine were increased. Renal doppler USG revealed increased renal parenchymal echogenicity. Immunosuppressive drug levels were in normal range. Renal biopsy was consistent with acute cellular rejection and treatment was started. Fever appeared on the following week. Immunosuppressants doses were reduced; antibiotics started empirically. HRCT revealed multiple nodules, lymphadenopathies and pleural effusion. C. neoformans was detected in blood culture. Detailed history revealed the patient was pigeon feeder. Amphotericin B and fluconazole was started. On follow up BPAP was needed owing respiratory distress. Blood culture became negative on the 13th day of treatment. The treatment of the patient was completed in six weeks and followed by prophylaxis. The patient is now being followed up at baseline creatinine 1.73 mg / dl in the 1st year after discharge. We would like to remind that opportunistic fungal infections may also be the cause of fever in solid organ transplant patients. It should be noted these infections may result with high mortality without early diagnosis and appropriate treatment.

Comparing Diagnostic Value of Renal Parenchymal Resistive Index And Cortical Echogenicity in Chronic Kidney Disease Patients

Background: Chronic kidney disease (CKD) is a clinically impaired kidney degradation syndrome, which commonly is diagnosed based on glomerulus filtration rate (GFR). Renal parenchymal resistive index and the renal cortex echogenicity are ultrasound parameters that have been reported correlate with GFR values. This study aims to determine the sensitivity, specificity, positive predictive value, and negative predictive value between renal intra-parenchymal resistive index and renal cortical echogenicitybased on GFR in CKD patients.Materials and Methods: This study is a cross sectional design. A renal ultrasound examination was performed to forty one CKD patients to assess the resistive index of the renal intra-parenchymal artery and the echogenicityof the renal cortex. The creatinine serum levels were obtained from the patients, as the gold standard of CKD diagnosis. Statistical data processing uses diagnostic test and Inter class Correlation Coefficients (ICC).Results: The sensitivity, specificity, positive predictive value, and negative predictive value of renal intraparenchymal resistive indexes were 23%, 79%, 33%, and 69% respectively. Sensitivity, specificity, positive predictive value, and negative predictive value between renal cortex echogenicity were 23%, 96%, 75%, and 73% respectively. The ICC analysisreported a Single Rater value of 0.1538 and Average of Raters 0.3528.Conclusion: Renal intra-parenchymal resistive artery was more specific than renal cortex echogenicity for diagnosing patients with chronic kidney disease.International Journal of Human and Health Sciences Vol. 04 No. 03 July’20 Page : 194-199

Comparison of Primary and Recurrent Urinary Tract Infections in Children.

AimWe aimed to compare the demographic and ultrasound data regarding first-episode urinary tract infections with recurrent infections in children.MethodsA total of 509 children aged 0-16 years who were diagnosed to have a urinary tract infection (UTI) as confirmed with positive urinary culture tests were retrospectively investigated. A comparison of baseline parameters, responsible pathogen incidences, and ultrasound findings was made between children who had a single episode of UTI (n=418, 82.1%) with those having second or more recurrent episodes of urinary tract infection (n=91, 17.9%).ResultsThe mean age of children with a single episode of urinary tract infection was significantly lower than those who had recurrent urinary tract infection (5.33±4.38 vs. 7.01±4.83 years, p=0.003). Incidences of Escherichia coli and Enterococcus faecalis was significantly higher in patients with recurrent urinary tract infection than those who had single episode (n=315, 75.4% vs. n=80, 87.9%, p=0.009 and n=8, 1.9% vs. n=9, 9.9%, p<0.001, respectively). An abnormal ultrasound was significantly more common in patients with recurrent urinary tract infection than those who had a single episode (n=41, 54.6% vs. n=59, 22.7%). Increased renal parenchymal echogenicity (p=0.002), bladder cystitis (p=0.01) and hydronephrosis (p<0.001) were significantly more common in patients with recurrent urinary tract infection than those who had a single episode of urinary tract infection.ConclusionEscherichia coli and Enterococcus faecalis were the most common responsible pathogens in recurrent urinary tract infections. Structural changes, such as hydronephrosis and bladder cystitis, are likely to have an important role in the etiology of children with recurrent urinary tract infection.

Sonographic evaluation of renal changes among drug-dependent and drug-naive adult patients with human immunodeficiency virus/acquired immunodeficiency syndrome in Kano, Nigeria

Context: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) remains a major challenge globally. HIVassociated nephropathy is the third most common cause of endstage renal failure and more prevalent among AfricanAmericans with HIV compared with other races. Aims: This study evaluated sonographic renal changes in drugdependent and drugnaive patients with HIV/AIDS in Kano, Nigeria.Materials and Methods: A prospective and comparative study involving 190 each of drugdependent and drugnaive patients were conducted. Renal sonography was performed using digital ultrasonic diagnostic imaging system, equipped with a 3.5 MHz curvilinear transducer. Statistical analysis used: An independent ttest and Mann–Whitney Utest were used to compare the renal volume and mean rank of the renal parenchymal echogenicity between drugdependent and drugnaive patients. Statistical significance was considered at P

Sonographic Assessment of Kidneys in Human Immunodeficiency Virus Sero-Positive Patients: A systematic Review

Background: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) remains a major challenge globally, and approximately 180,000 people died from AIDS-related illnesses in Nigeria in 2015. HIV associated nephropathy is the third most common cause of end-stage renal failure. Objectives: To review published original research articles on the sonographic evaluation of kidneys in HIV seropositive patients, identifying missing gaps and coming up with an area of further study. Methodology: The study was retrospective and a secondary source of data from published original research articles was used. The search was performed through Google search using Google Scholar, EMBASE, PubMed and Medline. All the published original research articles in the English language and the availability of full-text articles were included in the study. The results: An electronic search using the search terms had identified 58 related published articles, but only 12 articles were reviewed. This study found out that human immunodeficiency virus-associated nephropathy (HIVAN) to be most predominant renal disease in HIV positive patients leaving in sub-Saharan Africa with increased renal parenchymal echogenicity and decreased corticomedullary differentiation sonographically, which correlate in raised of serum creatinine level and the degree of patients' immune competence (CD4 count). Few studies correlated the sonographic findings with histopathological feature and none use Doppler ultrasound. Conclusion: This study has identified a correlation between the sonographic findings with the histopathological features and the use of Doppler ultrasound as the missing gaps from the previously published research articles in the subject area.

Acute kidney injury associated with Yersinia pseudotuberculosis infection: Forgotten but not gone.

BackgroundYersinia pseudotuberculosis is known to cause fever, gastroenteritis, or acute kidney injury (AKI). There have been several Y. pseudotuberculosis infection outbreaks to date associated with ingestion of contaminated food or unsterile water. While this disease was considered to have practically been eradicated with the improvement in public health, we encountered several cases of AKI associated with Yersinia infection.MethodsWe retrospectively collected data from medical records of patients with suspected Y. pseudotuberculosis infection who visited Seoul National University Children’s Hospital in 2017.ResultsThere were nine suspected cases of Yersinia infection (six males and three females; age range 2.99–12.18 years). Among them, five cases occurred in May, and seven patients were residing in the metropolitan Seoul area. Three patients had history of drinking mountain water. Every patient first presented with fever for a median of 13 days, followed by gastrointestinal symptoms and oliguria. Imaging studies revealed mesenteric lymphadenitis, terminal ileum wall thickening, and increased renal parenchymal echogenicity. Creatinine levels increased to 5.72 ± 2.18 mg/dL. Urinalysis revealed sterile pyuria, proteinuria, and glycosuria. Oliguria continued for 4 to 17 days, and two patients required dialysis; however, all of them recovered from AKI. Mucocutaneous manifestations developed later. In the diagnostic work-up, Yersinia was isolated from the stool culture in one patient. Anti-Yersinia immunoglobulin (Ig) A and IgG were positive in 6 patients.ConclusionY. pseudotuberculosis infection is an infrequent cause of interstitial nephritis presenting with AKI. When a patient presents with fever, gastroenteritis, and AKI not resolving despite hydration, the clinician should suspect Y. pseudotuberculosis infection.