Resistive Index for the Evaluation of Renal Damage in Diabetes Mellitus Type 2

Abstract

Background: One of the most common causes of renal impairment and development of chronic kidney disease is diabetes mellitus type 2 (DM 2). The aim of this prospective study was to determine the role of Resistive Index (RI) as a non-invasive marker for the evaluation of renal impairment in patients with DM 2. Material and Methods: 47 patients with DM 2 in mean age 62.66 ± 10.081 years were included in the study for the period of one year. All of them were with well-compensated diabetes mellitus (HbA1c < 7.0%) and optimal control of arterial hypertension. Hematological analysis of blood were carried out. Serum and urine biochemical parameters were tested, glomerular filtration rate (GFR) was calculated, and abdominal ultrasound with measure of RI was done. Results: Patients with RI < 0.7 and those with RI ≥ 0.7 did not differ significantly in terms of their age, sex, body mass index (BMI), duration of DM 2 and arterial hypertension, use of antihypertensive drugs and HbA1c (p > 0.05 for all). There was significant difference between the groups according to serum creatinine (p = 0.026), GFR (p = 0.044) and the degree of proteinuria (p = 0.001). There was a positive correlation between RI and serum creatinine (r = 0.418; p = 0.001) and between RI and proteinuria (r = 0.396; p = 0.004). A negative correlation relationship between RI and GFR values was found (r = −0.413; p = 0.011). Conclusions: RI may be used as an indicator for the assessment of the severity of renal impairment in patients with DM 2. It correlates well with serum creatinine, GFR and proteinuria, which are proven biochemical parameters indicating the degree of renal damage in patients with DM 2.

Korelasi resistive index ginjal dengan proteinuria pada pasien diabetes melitus tipe 2

“…2,3 Pada pasien diabetes dengan fungsi ginjal normal, 65% dari mereka yang terkena tipe 1 dan 25% dari mereka yang terkena tipe 2 memiliki nilai RI ≥0,70. 4 Pemeriksaan USG Doppler dengan color atau power Doppler, merupakan metode yang mudah diterapkan, non-invasif dan memiliki kemampuan tidak hanya untuk mengetahui karakteristik morfologi ginjal tapi dapat mendiagnosis stenosis arteri renalis, mengukur resistensi pembuluh darah parenkim ginjal. 5 Peningkatan resistive index menggambarkan adanya proses fibrosis renal, yang mengakibatkan pengurangan luas pembuluh darah intrarenal dan akibatnya terjadi peningkatan resistensi pembuluh darah intrarenal, sehingga resistive index ginjal dapat menjadi prediktor independen dari penurunan fungsi ginjal.…”

Correlación de albuminuria con el índice de resistencia de las arterias renales por ultrasonido Doppler como predictor de daño renal en pacientes con DM2

“…El índice de resistencia renal está estrechamente relacionado con la arteriolosclerosis renal y la mayoría de los estudios muestran que se aumenta en la DM2. Según algunos autores, la gravedad del daño renal se correlaciona bien con el aumento del índice de resistencia 8 .…”