title: Association of Renal Elasticity and Renal Function Progression in Patients with Chronic Kidney Disease Evaluated by Real-Time Ultrasound Elastography.
abstract: Glomerulosclerosis and tubulointerstitial fibrosis are associated with lower renal parenchymal elasticity. This study was designed to evaluate the predictive ability of renal elasticity in patients with chronic kidney disease (CKD). 148 non-CKD patients and 227 patients with CKD were recruited. 145 (38.7%) were female, 166 (73.1%) had diabetes, the mean estimated glomerular filtration rate (eGFR) was 33.9 ± 15.8 ml/min/1.73 m2and the median urinary protein-to-creatinine ratio (UPCR) 502 (122-1491) mg/g. Patients with later stages of CKD had lower renal elasticity values, indicating stiffer kidneys (p < 0.001), and smaller kidney (p < 0.001). Renal elasticity correlated with log-transformed UPCR (β = -7.544, P < 0.001). Renal length correlated with age (β = -0.231, P < 0.001), sex (β = -3.730, P < 0.001), serum albumin level (β = -3.024, P = 0.001), body mass index (β = 0.390, P = 0.009) and eGFR (β = 0.146, P < 0.001). In fully-adjusted logistic regression model, the odds ratio (OR) per 10 unit change in renal elasticity for rapid renal deterioration was 0.928 (95% CI, 0.864-0.997; P = 0.042). The OR per 1 mm change in renal length for rapid renal deterioration was 1.022 (95% CI, 0.994-1.050; P = 0.125). Renal elasticity is associated with proteinuria and rapid renal deterioration in patients with CKD.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.|Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Lipid Science and Aging Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Physiology &Biophysics, University of California at Irvine, Irvine, CA 92697, USA.|Sue and Bill Gross Stem Cell Research Center, University of California at Irvine, Irvine, CA 92697, USA.
authors.forename: Hugo You-Hsien
authors.initials: HY
authors.lastname: Lin
authors.affiliation: Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Yu-Li
authors.initials: YL
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.|Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Kun-Der
authors.initials: KD
authors.lastname: Lin
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Yi-Wen
authors.initials: YW
authors.lastname: Chiu
authors.affiliation: Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Shyi-Jang
authors.initials: SJ
authors.lastname: Shin
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.|Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Lipid Science and Aging Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Shang-Jyh
authors.initials: SJ
authors.lastname: Hwang
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Hung-Chun
authors.initials: HC
authors.lastname: Chen
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Chi-Chih
authors.initials: CC
authors.lastname: Hung
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D015992:Body Mass Index; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods; D005260:Female; D005919:Glomerular Filtration Rate; D005923:Glomerulosclerosis, Focal Segmental / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D009929:Organ Size; D011379:Prognosis; D011507:Proteinuria / Q000097:blood; D051436:Renal Insufficiency, Chronic / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D012737:Sex Factors
chemical_list: D015415:Biomarkers; D003404:Creatinine