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Value of Doppler ultrasonography in predicting deteriorating renal function after spinal cord injury

Ruolo dell’ecografia Doppler nel predire il deterioramento della funzionalità renale a seguito di lesione del midollo spinale

  • Ultrasonography / Ecografia
  • Published:
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Abstract

Purpose

The authors sought to study the relationship between Doppler ultrasonography and deterioration of renal function in patients with spinal cord injury.

Materials and methods

Nineteen patients who underwent follow-up with radioisotopic renography were evaluated. Median patient age was 50 [interquartile ratio (IQR) 35–57] years, and time since injury was 4.7 (IQR 1.3–9.2) years. Following Doppler ultrasound, patients were divided into groups based on baseline renal resistive index (RRI): normal RRI (≤0.7), group 1 (n=14); and abnormal RRI (> 0.7), group 2 (n=5), and were followed up with radioisotopic renography 1 or more years later. Annual change in effective renal plasma flow (ERPF) was analysed.

Results

The 38 kidneys (two for each patient) were stratified by initial RRI, with 28 in group 1 and ten in group 2. Result of univariate generalised estimation equation (GEE) analysis for the factors affecting the change in effective renal plasma flow (ERPF) indicated that the high RRI value (RRI > 0.7) correlated with the change in ERPF. ERPF value in group 2 was significantly decreased (p=0.01) by an average of 60.33 ml/min (standard error = 23.26).

Conclusions

An RRI > 0.7 is a risk factor for future renal function deterioration in patients with spinal cord injury. Thus, annual Doppler ultrasonography to assess the RRI and the degree of hydronephrosis is recommended.

Riassunto

Obiettivo

Scopo dello studio è indagare la relazione tra i rilievi Doppler ultrasonografici ed il deterioramento della funzione renale in pazienti con lesione del midollo spinale.

Materiali e metodi

Sono stati valutati 19 pazienti con età media pari a 50 anni [scarto interquartilico (IQR) 35–57] con tempo medio trascorso dal trauma di 4,7 anni (IQR 1,3–9,2), seguiti in follow-up mediante renografia radioisotopica. Tramite valutazione Doppler ultrasonografica, i pazienti sono stati divisi in gruppi basandosi sull’indice di resistività renale (IRR); gruppo 1 (n=13) con IRR normale (≤0,7) e gruppo 2 (n=6) con IRR anormale (>0,7); i Pazienti sono stati in seguito rivalutati almeno un anno dopo, mediante renografia radioisotopica.

Risultati

Trentotto reni sono stati assegnati sulla base dell’IRR iniziale in numero di 28 al gruppo 1 e di 10 al gruppo 2. L’analisi univariata mediante equazione di stima generalizzata (GEE) per i fattori che influenzano il flusso renale plasmatico effettivo (FPRE), ha indicato che un elevato IRR (>0,7) correla con il cambiamento del FPRE. Il valore del FPRE nel gruppo 2 è significativamente diminuito (p=0,01), in media 60,33 ml/min (errore standard=23,26).

Conclusioni

Un IRR >0,7 rappresenta un fattore di rischio per il deterioramento della funzionalità renale in Pazienti con lesioni del midollo spinale. Pertanto si raccomanda l’ecografia Doppler annuale per la stima dell’IRR e dell’entità d’idronefrosi.

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Authors and Affiliations

  1. Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan

    Fan-Fei Tseng

  2. Maria Social Welfare Foundation, Taichung, Taiwan

    Fan-Fei Tseng

  3. Department of Physical Medicine & Rehabilitation, Chung Shan Medical University Hospital, Taichung, Taiwan

    Yu-Hui Huang, Su-Ju Tsai, Chi-Chung Ho & Liu-Ing Bih

  4. School of Medicine, Chung Shan Medical University, Taichung, Taiwan

    Yu-Hui Huang, Sung-Lang Chen, Su-Ju Tsai & Liu-Ing Bih

  5. Department of Urology, Chung Shan Medical University Hospital, Taichung, Taiwan

    Sung-Lang Chen

  6. No. 158, Chung-Der first road, Taichung, 406, Taiwan

    Liu-Ing Bih

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  1. Fan-Fei Tseng
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  2. Yu-Hui Huang
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Correspondence to Liu-Ing Bih.

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Tseng, FF., Huang, YH., Chen, SL. et al. Value of Doppler ultrasonography in predicting deteriorating renal function after spinal cord injury. Radiol med 117, 500–506 (2012). https://doi.org/10.1007/s11547-011-0732-3

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  • DOI: https://doi.org/10.1007/s11547-011-0732-3

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