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 m2 and 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.

Advanced Ultrasound Techniques for Pediatric Imaging

“…Although further research is needed, elastography may be used to diagnosis other pathologies, including severe brain injury, 39 fibrotic bowel segment, 21,40 and renal fibrosis. 41 Noninvasive inference of the severity of brain injury is of clinical importance because invasive intracranial pressure measurements are not without risks. Severe anoxic brain injury can be quantitatively detected by elastography as an increase in stiffness due to brain edema, although the exact biochemical and physiologic basis of such elasticity change in the affected tissue warrants further research.…”

“…In patients with chronic kidney disease, elastography may be of prognostic value in identifying those at risk for renal function deterioration. 41…”

A Deep Learning Framework for Single-Sided Sound Speed Inversion in Medical Ultrasound

“…Mechanical tissue properties, tissue structures, and the spatial arrangement of properties and structures are useful in disease diagnosis in various organs, including the kidneys [1], [2], thyroid, muscle, breast [3], [4], liver [5], [6], and prostate. Tracking changes in tissue properties, tissue structure, and the spatial distribution of both is useful for monitoring disease progression as well as response to therapeutic interventions.…”

Transfer learning for diagnosis of congenital abnormalities of the kidney and urinary tract in children based on ultrasound imaging data

“…Children with congenital abnormalities of the kidney and urinary tract (CAKUT) face many challenges and early detection of CAKUT can help prevent the progression of kidney disease to kidney failure [1]. Ultrasound (US) imaging plays a key role in CAKUT diagnosis because anatomic measures derived from US imaging data, such as renal elasticity, renal parenchymal area, maximum renal length, and cortical thickness, are correlated with kidney function [2,3]. More recently, texture analysis of imaging data has demonstrated improved performance for predicting change in kidney function [4].…”