Doppler ultrasoundgraphy capability in the evaluation of renal circulation in patients with type 2 diabetes mellitus and chronic kidney disease


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Abstract

Abstract. The 72 patients with type 2 diabetes mellitus and chronic kidney were examined to clarify Doppler ultrasound capability in assessing the renal circulation. Hemodynamics changes in kidney tissue appeared on early stage of diabetic kidney disease. Intrarenal hemodynamics disturbances in patients with type 2 diabetes mellitus is revealed through a decrease in the minimum blood flow velocity and an increase in the intrarenal vascular resistance parameters. We found the correlation between dopplerographic indicators, kidney functions and other parameters (age, disease duration, glycated hemoglobin level), which play a pathogenetic role in diabetic kidney disease. Serum creatinine level and glomerular filtration rate were indicators of renal hemodynamic changes. Resistant index above 0,7 conventional units, pulsatility index above 1,54 conventional units, systolic diastolic ratio above 3,8 conventional units were ultrasound signs of kidney damage. Patients without standard signs of chronic kidney disease have diagnostically significant index of resistance in 72% of cases, a pulsation index in 50%, a systolic-diastolic ratio in 28%. Renal blood flow examination in right segmental artery area will be use for non-invasive diagnosis and estimation of kidney dysfunction in patients with type 2 diabetes mellitus.

About the authors

D. A. Shipilova

Military medical academy of S.M. Kirov

Author for correspondence.
Email: vmeda-nio@mil.ru
Russian Federation, Saint Petersburg

O. A. Nagibovich

Military medical academy of S.M. Kirov

Email: vmeda-nio@mil.ru
Russian Federation, Saint Petersburg

N. A. Shchukina

Military medical academy of S.M. Kirov

Email: vmeda-nio@mil.ru
Russian Federation, Saint Petersburg

References

  1. Ворожцова, И.Н. Диагностическая эффективность лучевых и лабораторных показателей как маркеров ранней диагностики диабетической нефропатии у больных сахарным диабетом 1-го типа / И.Н. Ворожцова [и др.] // Современные проблемы науки и образования. – 2017. – Т. 2. – С. 36.
  2. Дедов, И.И. Алгоритмы специализированной медицинской помощи больным сахарным диабетом / И.И. Дедов, М.В. Шестакова, А.Ю. Майоров // Сахарный диабет. – 2019. – Т. 22, № S1. – С. 68–79.
  3. Капустин, С.В. Ультразвуковое исследование в урологии и нефрологии / С.В. Капустин, Р. Оуен, С.И. Пиманов. – М.: Умный доктор, 2017. – 176 с.
  4. Климонтов, В.В. Цистатин С и коллаген IV типа в диагностике хронической болезни почек у больных сахарным диабетом 2-го типа / В.В. Климонтов [и др.] // Сахарный диабет. – 2015. – Т. 18, № 1. – С. 87–93
  5. Клинические практические рекомендации международного общества нефрологов по диагностике и лечению хронической болезни почек, 2012 // Нефрология и диализ. – 2017. – Т. 19, № 1. – С. 59–61.
  6. Кошельская, О.А. Маркеры хронической болезни почек и нарушения ренальной гемодинамики у пациентов с контролируемой артериальной гипертонией высокого риска / О.А. Кошельская, О.А. Журавлева // Росс. кардиол. журн. – 2018. – № 10. – С. 112–118.
  7. Нагибович, О.А. Возможности допплерографии в диагностике функционального почечного резерва / О.А. Нагибович, Д.А. Шипилова // Medline.ru. Росс. биомед. журн. – 2018. – Т. 19, № 4. – С. 682–692.
  8. Шамхалова, М.Ш. Эпидемиология хронической болезни почек в Российской Федерации по данным федерального регистра взрослых пациентов с сахарным диабетом (2013–2016 гг.) / М.В. Шамхалова [и др.] // Сахарный диабет. – 2018. – Т. 21, № 3. – С. 160–169.
  9. Шилов, Е.М. Нефрология. Клинические рекомендации / Е.М. Шилов, А.В. Смирнов, Н.Л. Козловская. – М.: ГЭОТАР-Медиа, 2020. – 856 с.
  10. Bruno, R.M. Dynamic evaluation of renal resistive index in normoalbuminuric patients with newly diagnosed hypertension or type 2 diabetes / R.M. Bruno [et al.] // Diabetologia. – 2011. – Vol. 54, № 9. – P. 2430–2439.
  11. Dayem, S. Follow Up of Value of the Intrarenal Resistivity Indices and Different Renal Biomarkers for Early Identification of Diabetic Nephropathy in Type 1 Diabetic Patients / S. Dayem // Open Access Macedonian Journal of Medical Sciences. – 2017. – Vol. 5, № 2. – P. 188–192.
  12. Genov, D. Resistive Index for the Evaluation of Renal Damage in Diabetes Mellitus Type 2 / D. Genov // Open Journal of Internal Medicine. – 2018. – Vol. 8, № 2. – P. 160.
  13. Kim, J.H. Resistive index as a predictor of renal progression in patients with moderate renal dysfunction regardless of angiotensin converting enzyme inhibitor or angiotensin receptor antagonist medication / J.H. Kim // Kidney research and clinical practice. – 2017. – Vol. 36, № 1. – P. 58–67.
  14. Kopel, J Evolving spectrum of diabetic nephropathy / J. Kopel, C. Pena-Hernandez, K. Nugent // World journal of diabetes. – 2019. – Vol. 10, № 5. – P. 269.
  15. Mancini, M. Renal duplex sonographic evaluation of type 2 diabetic patients / M. Mancini [et al.] // Journal of Ultrasound in Medicine. – 2013. – Vol. 32, № 6. – P.1033–1040.
  16. Spatola, L. Doppler ultrasound in kidney diseases: a key parameter in clinical long-term follow-up / L. Spatola, S. Andrulli // Journal of ultrasound. – 2016. – Vol. 19, № 4. – P. 243–250.
  17. Sugiura, T. Resistive index predicts renal prognosis in chronic kidney disease / T. Sugiura, A. Wada // Nephrology Dialysis Transplantation. – 2009. – Vol. 24, № 9. – P. 2780–2785.
  18. Tai, H, Longitudinal follow-up study of the retrobulbar and intrarenal hemodynamics in patients with T2DM / H. Tai [et al.] // Medicine (Baltimore). – 2019. – Vol. 98, № 46. – P. 17792.
  19. Xu, H. Renal resistive index as a novel indicator for renal complications in high-fat diet-fed mice / H. Xu [et al.] // Kidney and Blood Pressure Research. – 2017. – Vol. 42, № 6. – P. 1128–1140.

Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. Determination of the threshold values of RI, PI, S / D, indicating the presence of signs of CKD in patients with type 2 diabetes

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Copyright (c) 2020 Shipilova D.A., Nagibovich O.A., Shchukina N.A.

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