Juan Guo, Xiaoyu Li, Qinjie Weng, Zhifang Yang, Yunyun Hu, Fuzhou Yi, Yue Song, Ri Ji
{"title":"改进糖尿病肾病的无创诊断：肾动脉阻力指数的作用。","authors":"Juan Guo, Xiaoyu Li, Qinjie Weng, Zhifang Yang, Yunyun Hu, Fuzhou Yi, Yue Song, Ri Ji","doi":"10.1002/jcu.24084","DOIUrl":null,"url":null,"abstract":"<p><strong>Rationale and objectives: </strong>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).</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.2000,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Refining Non-Invasive Diagnosis of Diabetic Nephropathy: The Role of Renal Artery Resistive Index.\",\"authors\":\"Juan Guo, Xiaoyu Li, Qinjie Weng, Zhifang Yang, Yunyun Hu, Fuzhou Yi, Yue Song, Ri Ji\",\"doi\":\"10.1002/jcu.24084\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Rationale and objectives: </strong>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).</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":15386,\"journal\":{\"name\":\"Journal of Clinical Ultrasound\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2025-05-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Ultrasound\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jcu.24084\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ACOUSTICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Ultrasound","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jcu.24084","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ACOUSTICS","Score":null,"Total":0}
Refining Non-Invasive Diagnosis of Diabetic Nephropathy: The Role of Renal Artery Resistive Index.
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.
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.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
