Early evaluation of renal hemodynamic alterations in type I diabetes mellitus with duplex ultrasound.
To evaluate the role of renal duplex ultrasonography in the detection of early alteration of renal blood flow in type I diabetic patients, we studied with duplex ultrasound 32 patients with type I diabetes mellitus (19 males, 13 females, age range 8-19 years) and 35 age and sex-matched controls. The resistivity indices (RIs) and pulsatility indices (PIs) of the main renal as well as intra-renal arteries were calculated. Compared with the healthy control subjects, diabetic patients had significantly higher resistivity indices (RIs) in the intrarenal (segmental, arcuate and interlobar) arteries (P= 0.001). The study, also revealed a significantly positive correlation between the RIs in the intrarenal arteries in diabetics and the albumin/creatinine ratio (r= 0.54, 0.52 and 0.51 respectively), glycated hemoglobin (r= 0.61, 0.59 and 0.63 respectively), as well as the estimated GFR (e-GFR) (r= 0.53, 0.51 and 0.57 respectively). We conclude that the current study documented early intra-renal hemodynamic alterations in the form of pathologically elevated intrarenal RIs. This denotes the potential usefulness of duplex evaluation of the intrarenal arteries, as a noninvasive procedure, for monitoring type 1 diabetic patients to predict those at risk of diabetic nephropathy.
Department of Pediatrics, Center of Pediatric Nephrology and Transplantation, Cairo University, Egypt.
Aasem
A
Saif
Neveen A
NA
Soliman
Alaa
A
Abdel-Hameed
D000293:Adolescent; D000419:Albuminuria / Q000000981:diagnostic imaging / Q000209:etiology; D015415:Biomarkers / Q000097:blood / Q000652:urine; D016022:Case-Control Studies; D002648:Child; D003404:Creatinine / Q000097:blood / Q000652:urine; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000000981:diagnostic imaging / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000378:metabolism; D006439:Hemodynamics; D006801:Humans; D007668:Kidney / Q000098:blood supply* / Q000503:physiopathology; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011673:Pulsatile Flow; D012079:Renal Circulation; D013997:Time Factors; D018615:Ultrasonography, Doppler, Color; D014655:Vascular Resistance; D055815:Young Adult
D015415:Biomarkers; D003404:Creatinine; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human