4.2 Article

Resistivity index in the diagnosis and assessment of loss of renal function in diabetic nephropathy

Journal

CARDIOVASCULAR JOURNAL OF AFRICA
Volume 33, Issue 1, Pages 26-32

Publisher

CLINICS CARDIVE PUBL PTY LTD
DOI: 10.5830/CVJA-2021-032

Keywords

chronic kidney disease; diabetes mellitus; diabetic nephropathy; intrarenal artery haemodynamics; resistivity index

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The study revealed that intrarenal artery resistivity index was higher in patients with both diabetic nephropathy and diabetes mellitus without nephropathy, with elevated glycated haemoglobin (HbA1c) levels and hypertension being predictors of high RI in these patients.
Objective: The aim of this study was to determine the haemodynamics of the intrarenal arteries from the relationship between resistivity index (RI) and kidney function, and to identify the predictors of high RI among patients with diabetic nephropathy (DN) and those with diabetes mellitus (DM) without DN. Methods: This was a cross-sectional survey of 133 participants, comprising 40 subjects with DM without DN, 53 with DM with DN and 40 healthy controls. Information obtained was demographics, lifestyle, medical and medication histories, while anthropometric and blood pressure measurements were taken. Albuminuria and estimated glomerular filtration rate were determined and RI was measured using a Doppler ultrasound scan. Results: The mean intrarenal artery RIs were higher among the patients with DM without DN (0.60 +/- 0.04) and the group with DM with DN (0.61 +/- 0.04) than in the controls (0.56 +/- 0.04) (p = 0.02). Glycated haemoglobin (HbA1c) predicted high RI in the DM without DN group (OR 2.81; CI: 1.73-9.03) while hypertension (OR 3.60; CI: 1.06-12.22) predicted high RI in the DM with DN group. Conclusion: Elevated intrarenal artery RI was prevalent among patients with DM without DN and those with DM with DN, while elevated HbA1c level and hypertension predicted elevated RI in subjects with DM without DN and those with DM with DN.

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