title: Role of ultrasonographic chronic kidney disease score in the assessment of chronic kidney disease.
abstract: OBJECTIVE
  Ultrasonography (US) is an inexpensive, noninvasive and easy imaging procedure to comment on the kidney disease. Data are limited about the relation between estimated glomerular filtration rate (e-GFR) and all 3 renal US parameters, including kidney length, parenchymal thickness and parenchymal echogenicity, in chronic kidney disease (CKD). In this study, we aimed to investigate the association between e-GFR and ultrasonographic CKD score calculated via these ultrasonographic parameters.
  
  
  METHODS
  One hundred and twenty patients with stage 1-5 CKD were enrolled in this study. The glomerular filtration rate was estimated by the Chronic Kidney Disease Epidemiology Collaboration equation. US was performed by the same radiologist who was blinded to patients' histories and laboratory results. US parameters including kidney length, parenchymal thickness and parenchymal echogenicity were obtained from both kidneys. All 3 parameters were scored for each kidney, separately. The sum of the average scores of these parameters was used to calculate ultrasonographic CKD score.
  
  
  RESULTS
  The mean age of patients was 63.34 ± 14.19 years. Mean kidney length, parenchymal thickness, ultrasonographic CKD score and median parenchymal echogenicity were found as 96.2 ± 12.3, 10.97 ± 2.59 mm, 6.28 ± 2.52 and 1.0 (0-3.5), respectively. e-GFR was positively correlated with kidney length (r = 0.343, p < 0.001), parenchymal thickness (r = 0.37, p < 0.001) and negatively correlated with CKD score (r = -0.587, p < 0.001) and parenchymal echogenicity (r = -0.683, p < 0.001). Receiver operating characteristic curve analysis for distinction of e-GFR lower than 60 mL/min showed that the ultrasonographic CKD score higher than 4.75 was the best parameter with the sensitivity of 81% and positive predictivity of 92% (AUC, 0.829; 95% CI, 0.74-0.92; p < 0.001).
  
  
  CONCLUSIONS
  We found correlation between e-GFR and ultrasonographic CKD score via using all ultrasonographic parameters. Also, our study showed that ultrasonographic CKD score can be useful for distinction of CKD stage 3-5 from stage 1 and 2. We suggested that the ultrasonographic CKD score provided more objective data in the assessment of CKD.
authors: Division of Nephrology, Department of Internal Medicine, School of Medicine, Mustafa Kemal University, 31100, Antakya, Hatay, Turkey. drmustafayaprak@yahoo.com.
authors: Mustafa
authors: M
authors: Yaprak
authors: Department of Radiology, Batman Regional State Hospital, Batman, Turkey.
authors: Özgür
authors: Ö
authors: Çakır
authors: Division of Nephrology, Department of Internal Medicine, School of Medicine, Harran University, Şanlıurfa, Turkey.
authors: Mehmet Nuri
authors: MN
authors: Turan
authors: Department of Internal Medicine, Batman Regional State Hospital, Batman, Turkey.
authors: Ramazan
authors: R
authors: Dayanan
authors: Department of Biochemistry, Batman Regional State Hospital, Batman, Turkey.
authors: Selçuk
authors: S
authors: Akın
authors: Department of Biochemistry, Batman Regional State Hospital, Batman, Turkey.
authors: Elif
authors: E
authors: Değirmen
authors: Division of Medical Oncology, Batman Regional State Hospital, Batman, Turkey.
authors: Mustafa
authors: M
authors: Yıldırım
authors: Division of Nephrology, Department of Internal Medicine, School of Medicine, Mustafa Kemal University, 31100, Antakya, Hatay, Turkey.
authors: Faruk
authors: F
authors: Turgut
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging* / Q000473:pathology*; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011237:Predictive Value of Tests; D012372:ROC Curve; D051436:Renal Insufficiency, Chronic / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D016037:Single-Blind Method; D014463:Ultrasonography
keywords: Chronic kidney disease; Kidney length; Parenchymal echogenicity; Parenchymal thickness; Ultrasonographic chronic kidney disease score; e-Glomerular filtration rate