[Computerized tomography in the study of the diabetic kidney].
OBJECTIVE
We investigated whether any morphometric or densitometric changes are detectable in the kidneys of type 2 diabetic patients.


METHODS
We retrospectively reviewed the CT findings of 40 diabetic patients and of 20 non-diabetics (the control group) submitted to triphasic helical CT for different abdominal conditions. The type 2 diabetic patients were 23 men and 17 women, mean age 62 years, while the nondiabetic controls were 12 men and 8 women, mean age 58 years. All the CT images were analyzed using the Multiplanar Reconstruction (MPR) software. We classified the diabetic patients as either nephropathic or non-nephropathic based on laboratory signs of renal disease, and divided them into three groups based on the duration of their diabetes (0-5 years, 5-10 years, > 10 years). We evaluated morphometric features, such as the presence of parenchymal or vascular calcifications, axial and coronal renal diameters, coronal renal area, and corticomedullary ratio, and densitometric and functional features, such as unenhanced renal density, cortical and medullary density in the arterial phase, parenchymal density in the nephrographic phase, and contrast elimination. We also compared the results in our subgroups of patients with those in the controls.


RESULTS
Both renal diameters on axial sections and cortical density in the arterial phase were significantly lower in the nephropathic group (p < 0.05) than in nonnephropathic patients and controls. The patients with shorter duration of their diabetes had significantly greater axial diameters (p < 0.05); a longer-standing disease correlated significantly (p < 0.05) with smaller axial diameters of kidneys and lower cortical density in the arterial phase. No significant correlation was found for any other parameter.


CONCLUSIONS
Renal diameters on axial and coronal sections and cortical density in the arterial phase can be useful indices of early nephropathy in diabetic patients. Further studies are warranted to make these findings suitable for use in clinical practice.
Angelelli
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G
Istituto di Radiologia, Università degli Studi, Bari, BA. g.angelelli@radiologia.uniba.it
Stabile Ianora
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Scardapane
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Rotondo
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D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging* / Q000473:pathology; D003928:Diabetic Nephropathies / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed