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Effect of proteinuria at relapse on shear wave velocity assessed using ultrasound elastography in children with idiopathic nephrotic syndrome

  • Original Article–Pediatrics
  • Published:
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Abstract

Purpose

Shear wave velocity (SWV) is an ultrasound elastography technique that provides much information for kidney disease assessment. However, the factors that alter SWV are not fully understood; it is unclear whether the variation in SWV seen in proteinuria associated with disease progression is due to tissue or proteinuria. This study investigated the effect of proteinuria on SWV.

Methods

This prospective observational study compared SWV at remission with SWV at relapse in children treated for idiopathic nephrotic syndrome (INS) between April 2020 and December 2023. All relapses without oral steroids during the observation period were measured. SWV at remission was defined as the date closest to relapse during which repeated measurements were taken approximately every 3 months after steroid discontinuation.

Results

Eight patients were treated for INS with a median observation period of 21.9 months (11.8–27.1). Of the 15 relapses, five that met the definition were considered for the study. The median interval between the measurement at relapse and remission was 40 days (11–55). SWV was significantly lower at relapse than remission (2.40 ± 0.20 m/s vs. 2.14 ± 0.15 m/s, P < 0.01).

Conclusions

SWV decreased in the presence of severe proteinuria at relapse compared to the remission measurements. Although more cases need to be studied, the decrease in SWV may reflect the mechanism by which protein leaks into the urine, not just a direct change caused by the presence of proteinuria.

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Data availability

The datasets generated during and/or analyzed in the present study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Acknowledgements

The authors thank the patients and their parents for their participation in this study.

Funding

This study received no specific grants from any funding agency in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo, 173-8605, Japan

    Tomohiko Nishino, Shinya Tomori, Sayaka Ono, Kazuhiro Takahashi & Masakazu Mimaki

Authors
  1. Tomohiko Nishino
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  2. Shinya Tomori
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  3. Sayaka Ono
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  4. Kazuhiro Takahashi
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  5. Masakazu Mimaki
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Contributions

All authors contributed to the study conception and design. Tomohiko Nishino: mainly drafted the manuscript, collected data, performed the statistical analysis, and prepared material. Shinya Tomori, Sayaka Ono, and Kazuhiro Takahashi: critically reviewed the manuscript. Masakazu Mimaki: supervised the whole study process. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Tomohiko Nishino.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The study was approved by the Teikyo University Ethical Review Board for Medical and Health Research Involving Human Subjects (approval number 20-195-11). All procedures involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Consent to participate/consent to publication

The study was presented on our university website, which allowed patients and their guardians to ask questions regarding the study and opt out of sharing data. Informed consent for the publication of and participation in the study was obtained before each patient underwent ultrasound elastography. The study was explained to all patients and their parents/guardians in plain language with explanatory documents, and written consent for participation in the research and its publication was obtained from the parents/guardians of all participants. Further, the right of parents/guardians to refuse to participate and withdraw consent at will was clarified.

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Nishino, T., Tomori, S., Ono, S. et al. Effect of proteinuria at relapse on shear wave velocity assessed using ultrasound elastography in children with idiopathic nephrotic syndrome. J Med Ultrasonics (2024). https://doi.org/10.1007/s10396-024-01455-7

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  • DOI: https://doi.org/10.1007/s10396-024-01455-7

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