Type 2 diabetes albuminuric and non‐albuminuric phenotypes have different morphological and functional ultrasound features of diabetic kidney disease

Abstract

Aims: Whether different diabetic kidney disease (DKD) phenotypes recognise differences in morphological and vascular properties of the kidney is still unexplored.We evaluated the potential role of kidney ultrasonography in differentiating DKD phenotypes in subjects with type 2 diabetes. Materials and Methods:This is a cross-sectional, single-centre study. Total (TRV) and parenchymal renal volumes (PRV) were calculated by applying the ellipsoid formula for conventional (2D) ultrasonography and with manual segmentation for 3D ultrasonography, and then adjusted for body surface area (aTRV, aPRV). Renal resistive index (RI) was contextually determined. DKD phenotypes have been defined based on increased urinary albumin-to-creatinine ratio (ACR >30 mg/g) and/or reduced eGFR (<60 ml/min/1.73 m 2 ). Recruitment was planned to have groups of the same size.Results: Among 256 subjects, 26.2% had No-DKD, 24.6% increased albuminuria only (Alb + ), 24.2% non-albuminuric DKD (Alb − DKD), and 25.0% albuminuric DKD

Intrarenal Resistive Index and Kidney Volume: Key Indicators of Early Diabetic Kidney Disease in Youth-Onset, Long-Duration Type 1 Diabetes

“…This non-invasive diagnostic method allows for real-time visualization of kidney size and conditions. Many previous studies suggested a correlation between an increase in total KV and DKD progression in individuals affected by both T1D and T2D, regardless of the presence of albuminuria [25][26][27]. This could be due to the accumulation of extracellular matrix, glomerular hyper ltration or hypertrophy, chronic in ammation, and brosis leading to kidney enlargement.…”