Role of duplex doppler ultrasound in evaluation of patients with diabetic nephropathy

Background
Color Doppler evaluation of the renal parenchyma may suggest functional or structural changes within the kidneys and could provide useful diagnostic and prognostic information in diabetic nephropathy.


Aim
The aim was to assess the usefulness of duplex sonography with Doppler waveform analysis in the evaluation and assessment of renal vascular resistance in diabetic patients.


Patients and methods
This case–control prospective study included a total of 30 patients: 20 diabetic patients and 10 healthy controls. Renal parameters such as renal length, renal parenchymal thickness, parenchymal echogenicity, intrarenal resistive index (RI), and biochemical parameters such as fasting blood sugar, serum creatinine, and urine protein were recorded in all study participants. For the purpose of comparison, the diabetic patients were further subdivided into preclinical nephropathy, incipient nephropathy, overt nephropathy, and renal failure subgroups based on the stage of diabetic renal disease.


Results
A progressive increase in renal RI values was noted with progression of diabetic nephropathy. RI values showed a positive correlation with albuminuria and serum creatinine, and this correlation was found to be statistically significant.


Conclusion
Intrarenal RI measured by color Doppler ultrasonography has an important value in identifying diabetic patients who are developing nephropathy and can be used as an additional diagnostic tool in diagnosing diabetic nephropathy as well as to monitor progression of nephropathy.