Diabetic nephropathy is a major microvascular complication of diabetes mellitus and is the most important, cause of death in type I diabetic patients, of whom 30%-40% eventually develop end-stage renal failure and 40% of type II diabetics are at risk of developing diabetic nephropathy. So early diagnosis and management of diabetic nephropathy are paramount for the survivability of diabetic patients not only because of the consequences of renal progression but also because of the strong association with the risk of developing the cardiovascular and cerebrovascular disease.
A total number of 142 subjects were enrolled in this present cross-sectional validation study in the department of Radiology Hayat Abad medical complex Peshawar during 1 year (2020) aim to evaluate the diagnostic usefulness of renal resistive index (RI) by duplex Doppler ultrasonography for detection of renal dysfunction i.e diabetic nephropathy in diabetic patients. Clinically diagnosed diabetic patients referred to the Department of Radiology in HMC for ultrasonography of the Kidneys, Ureters and Bladder (KUB) region or the whole abdomen were selected as samples. Biochemical reports (Serum creatinine and Urinary albumin) and the RI value of the intrarenal artery were correlated and analyzed. Those with incomplete data, current or past kidney diseases and current use of such drugs that could affect hemodynamic parameters were excluded. Both the kidneys were visualized by a commercially available real-time scanner equipped with a curvilinear transducer operating at 3.5 MHz. First Grayscale ultrasonography was done followed by a Color Doppler of the intrarenal artery and then RI was measured. The majority (47.3%) of patients were in the 5th decade with the mean age was of 46.5 ±7.7 years and ranging from 38 to 65 years in patients. Male was found to be 59.2% of diabetic patients with a male to female ratio of 1.2:1. A resistive index of (≥ 0.7) was found in 68.4% of patients with diabetes with a mean resistive index of 0.71±0.04. Positive correction between resistive index with serum creatinine (r=0.581, p<0.01) and albuminuria (r-0.725, p<0.01) were observed. It can be concluded that Resistive Index measured by duplex Doppler ultrasonography is a useful diagnostic modality for the detection of renal dysfunction in diabetic patients. Resistive Index has value in identifying diabetic patients who are developing nephropathy and can be used as an additional diagnostic tool. Also, it is well correlated with Serum Creatinine and Albuminuria which are the biochemical parameters to diagnose diabetic nephropathy.
