Increased renal cortical stiffness obtained by share-wave elastography imaging significantly predicts the contrast-induced nephropathy in patients with preserved renal function

  • Hilmi Erdem SumbulEmail author
  • Ayse Selcan Koc
  • Derya Demirtas
  • Hasan Koca
  • Burcak Cakir Pekoz
  • Feride Fatma Gorgulu
  • Yurdaer Donmez
  • Abdullah Orhan Demirtas
  • Mevlut Koc
  • Yahya Kemal Icen
Original Article



We aimed to investigate the relation between renal cortical stiffness (CS) obtained by shear-wave elastography (SWE) and contrast-induced nephropathy (CIN) development in interventional treatment-planned acute coronary syndrome (ACS) patients.


Our study group consisted of 465 ACS patients. Routine laboratory assessments, B-mode, Doppler, and SWE renal ultrasonography (USG) evaluations were performed. Renal resistive index (RRI), renal pulsatility index (RPI), and acceleration time (AT) and CS were measured. Patients were grouped as with and without CIN.


Among the study group, 55 patients (11.8%) had CIN. Age, diabetes mellitus (DM), hypertension (HT), basal creatinine, CK-MB and troponin I levels, contrast volume, contrast volume/weight ratio, SYNTAX score, RRI, RPI, AT, and CS values were significantly higher in patients with CIN. eGFR was lower in patients who developed CIN. Age, contrast volume/weight ratio, and CS were determined as independent predictors of CIN occurrence in logistic regression analysis. In multivariate logistic analysis, increase of age (each year), contrast volume/weight (each 0.2 mL/kg), and CS (each 1 kPa) were found to augment the development of CIN by 7.1, 59.5, and 62.3%, respectively. In the ROC analysis, CS had the highest AUROC value. The cutoff value of CS obtained by the ROC curve analysis was 7 kPa for the CIN development (sensitivity: 74.5%, specificity: 72.5%).


CS value is a simple, cheap, reproducible, noninvasive, and objective parameter for the detection of CIN development. ACS patients should be directed to renal USG, and routine CS value should be written besides USG measurements in reports.


Cortical stiffness Shear-wave elastography Contrast-induced nephropathy Acute coronary syndrome 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individuals who participated in the study.


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Copyright information

© Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2019

Authors and Affiliations

  • Hilmi Erdem Sumbul
    • 1
    Email author
  • Ayse Selcan Koc
    • 2
  • Derya Demirtas
    • 1
  • Hasan Koca
    • 3
  • Burcak Cakir Pekoz
    • 2
  • Feride Fatma Gorgulu
    • 2
  • Yurdaer Donmez
    • 3
  • Abdullah Orhan Demirtas
    • 3
  • Mevlut Koc
    • 3
  • Yahya Kemal Icen
    • 3
  1. 1.Department of Internal MedicineUniversity of Health Sciences - Adana Health Practice and Research CenterAdanaTurkey
  2. 2.Department of RadiologyUniversity of Health Sciences - Adana Health Practice and Research CenterAdanaTurkey
  3. 3.Department of CardiologyUniversity of Health Sciences - Adana Health Practice and Research CenterAdanaTurkey

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