Refining Non-Invasive Diagnosis of Diabetic Nephropathy: The Role of Renal Artery Resistive Index.

IF 1.2 4区医学 Q3 ACOUSTICS

Journal of Clinical Ultrasound Pub Date : 2025-05-27 DOI:10.1002/jcu.24084

Juan Guo, Xiaoyu Li, Qinjie Weng, Zhifang Yang, Yunyun Hu, Fuzhou Yi, Yue Song, Ri Ji

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引用次数: 0

Abstract

Rationale and objectives: Accurate differentiation between diabetic nephropathy (DN) and non-diabetic renal disease (NDRD) in type 2 diabetes mellitus (T2DM) patients is crucial for effective management. This study aims to evaluate the diagnostic value of ultrasound, particularly the renal artery resistive index (RRI), in distinguishing DN from NDRD in T2DM patients with early to mid-stage chronic kidney disease (CKD).

Materials and methods: This retrospective study included 164 T2DM patients with renal disease who underwent renal biopsy. Patients were divided into a derivation group (137) and a validation group (27). Each group was further categorized into DN and NDRD subgroups based on biopsy results. Clinical, laboratory, and ultrasound data, including RRI and diabetic retinopathy (DR), were analyzed to differentiate DN from NDRD.

Results: RRI values were significantly higher in DN patients, with optimal cutoffs of ≥ 0.72 for CKD stages 1-2 and ≥ 0.74 for stage 3. Combining RRI with DR achieved a specificity and positive predictive value (PPV) of 100% for diagnosing DN, confirmed in the validation group.

Conclusions: This study emphasizes the need for distinct RRI cutoff values for T2DM patients in early and mid-stage CKD. Stage-specific RRI cutoffs, combined with DR, provide a reliable, non-invasive approach to distinguish DN from NDRD, enhancing clinical decision-making.

查看原文本刊更多论文

改进糖尿病肾病的无创诊断：肾动脉阻力指数的作用。

理由和目的：准确区分2型糖尿病（T2DM）患者的糖尿病肾病（DN）和非糖尿病肾病（NDRD）是有效治疗的关键。本研究旨在评价超声尤其是肾动脉阻力指数（RRI）在T2DM合并早期至中期慢性肾脏疾病（CKD）患者中区分DN与NDRD的诊断价值。材料和方法：本回顾性研究纳入164例行肾活检的T2DM肾病患者。患者分为衍生组（137例）和验证组（27例）。每组根据活检结果进一步分为DN和NDRD亚组。分析临床、实验室和超声数据，包括RRI和糖尿病视网膜病变（DR），以区分DN和NDRD。结果：肾病患者的RRI值明显更高，CKD 1-2期的最佳临界值≥0.72，CKD 3期的最佳临界值≥0.74。RRI联合DR诊断DN的特异性和阳性预测值（PPV）为100%，在验证组中得到证实。结论：本研究强调T2DM合并早期和中期CKD患者需要明确的RRI临界值。特定阶段的RRI截止值与DR相结合，提供了一种可靠的、无创的方法来区分DN和NDRD，从而增强临床决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Ultrasound 医学-核医学

CiteScore

1.90

自引率

0.00%

发文量

248

审稿时长

6 months

期刊介绍： The Journal of Clinical Ultrasound (JCU) is an international journal dedicated to the worldwide dissemination of scientific information on diagnostic and therapeutic applications of medical sonography. The scope of the journal includes--but is not limited to--the following areas: sonography of the gastrointestinal tract, genitourinary tract, vascular system, nervous system, head and neck, chest, breast, musculoskeletal system, and other superficial structures; Doppler applications; obstetric and pediatric applications; and interventional sonography. Studies comparing sonography with other imaging modalities are encouraged, as are studies evaluating the economic impact of sonography. Also within the journal''s scope are innovations and improvements in instrumentation and examination techniques and the use of contrast agents. JCU publishes original research articles, case reports, pictorial essays, technical notes, and letters to the editor. The journal is also dedicated to being an educational resource for its readers, through the publication of review articles and various scientific contributions from members of the editorial board and other world-renowned experts in sonography.