Skip to main content
Log in

Usefulness of Doppler ultrasound for the early diagnosis of diabetic nephropathy in type 1 diabetes mellitus

  • Original Paper
  • Published:
Journal of Ultrasound Aims and scope Submit manuscript

Abstract

Purpose

Early diagnosis and management of diabetic nephropathy (DN) might prevent or delay its progression to end-stage renal disease. The purpose of this study was to investigate whether changes in the duplex Doppler resistivity index (RI) are useful for the early identification of renal involvement in children and adolescents with insulin-dependent diabetes mellitus and associated conditions.

Materials and methods

A total of 49 diabetic patients (two groups: 21 with DN and 28 without DN) were included in this study. DN was defined as 30–300 mg/l of albumin excretion in a random urine sample. The RI of the main renal arteries and their intrarenal branches (arcuate, interlobar) were evaluated with duplex Doppler ultrasound and correlated with age, renal length, duration of diabetes, and laboratory examinations.

Results

The mean age did not significantly differ between the two groups. The patients with DN had a significantly longer duration of type 1 diabetes (p = 0.02). The majority of patients (90.5%) had mild renal involvement with microalbuminuria and normal renal function. The mean RI was normal in both groups of patients, with no significant difference between the two groups.

Conclusion

The RI did not increase in the early clinical stage of DN and was not a reliable marker for the screening of DN in patients with type 1 diabetes mellitus.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Youssef DM, Fawzy FM (2012) Value of renal resistive index as an early marker of diabetic nephropathy in children with type-1 diabetes mellitus. Saudi J Kidney Dis Transpl 23:985–992. https://doi.org/10.4103/1319-2442.100880

    Article  PubMed  Google Scholar 

  2. Pelliccia P, Savino A, Cecamore C, Primavera A, Schiavone C, Chiarelli F (2008) Early changes in renal hemodynamics in children with diabetes: Doppler sonographic findings. Clin Ultrasound 36:335–340. https://doi.org/10.1002/jcu.20457

    Article  Google Scholar 

  3. Dayem SAE, Bohy AEME, Hamed M, Ahmed S (2017) Follow up of value of the intrarenal resistivity indices and different renal biomarkers for early identification of diabetic nephropathy in type 1 diabetic patients. Maced J Med Sci 20:188–192. https://doi.org/10.3889/oamjms.2017.034

    Article  Google Scholar 

  4. Ghaffar SAE, Kaffas KE, Hegazy R, Mostafa M (2010) Renal Doppler indices in diabetic children with insulin resistance syndrome. Pediatr Diabetes 11:479–486. https://doi.org/10.1111/j.1399-5448.2009.00628.x

    Article  CAS  Google Scholar 

  5. Spatola L, Andrulli S (2016) Doppler ultrasound in kidney diseases: A key parameter in clinical long-term follow-up. J Ultrasound 19:243–250. https://doi.org/10.1007/s40477-016-0201-x

    Article  PubMed  PubMed Central  Google Scholar 

  6. Afsar B, Elsurer R (2017) Increased renal resistive index in type 2 diabetes: clinical relevance, mechanisms and future directions. Diabetes Metab Syndr 11:291–296. https://doi.org/10.1016/j.dsx.2016.08.019

    Article  PubMed  Google Scholar 

  7. Nickavar A, Safarzadeh AE, Sotoudeh K, Otukesh H, Hooman N (2012) Mycophenolate mofetil for treatment of idiopathic nephrotic syndrome in children. Iran J Kidney Dis 6:346–349

    PubMed  Google Scholar 

  8. Saif A, Soliman NA, Abdel-Hameed A (2010) Early evaluation of renal hemodynamic alterations in type I diabetes mellitus with duplex ultrasound. Saudi J Kidney Dis Transpl 21:295–299

    PubMed  Google Scholar 

  9. Hasanović E, Tulumović D, Imamović G, Trnacević S (2010) The ultrasound characteristics of kidneys in children and adolescents with diabetes mellitus type 1. Lijec Vjesn 132:13–17

    PubMed  Google Scholar 

  10. Ghadirpour A, Tarzamni MK, Naghavi-Behzad M, Abedi-Azar S, Koushavar H, Nezami N (2014) Renal vascular Doppler ultrasonographic indices and carotid artery intima-media thickness in diabetic nephropathy. Med Ultrason 16:95–99. https://doi.org/10.11152/mu.2013.2066.162.ag1mkt2

    Article  PubMed  Google Scholar 

  11. Mancini M, Masulli M, Liuzzi R, Mainenti PP, Ragucci M, Maurea S, Riccardi G, Vaccaro O (2013) Renal duplex sonographic evaluation of type 2 diabetic patients. J Ultrasound Med 32:1033–1040. https://doi.org/10.7863/ultra.32.6.1033

    Article  PubMed  Google Scholar 

  12. Soldo D, Brkljacic B, Bozikov V, Drinkovic I, Hauser M (1997) Diabetic nephropathy. Comparison of conventional and duplex Doppler ultrasonographic findings. Acta Radiol 38:296–302. https://doi.org/10.1080/02841859709172067

    Article  CAS  PubMed  Google Scholar 

  13. Fallah M, Nafisi-Moghadam R, Nouri N (2012) Relationship between Intra-renal arterial resistance index (RI) and albuminuria in diabetic patients. Iranian J Diabetes Obes 4:7–10

    Google Scholar 

  14. Abd El Dayem S, El Bohy AM, El Shehaby A (2016) Value of the intrarenal arterial resistivity indices and different renal biomarkers for early identification of diabetic nephropathy in type 1 diabetic patients. J Pediatr Endocrinol Metab 29:273–279. https://doi.org/10.1515/jpem-2014-0397

    Article  CAS  PubMed  Google Scholar 

  15. Yilmaz MI, Saglam M, Qureshi AR, Carrero JJ, Caglar K, Eyileten T et al (2008) Endothelial dysfunction in type-2 diabetics with early diabetic nephropathy is associated with low circulating adiponectin. Nephrol Dial Transplant 23:1621–1627. https://doi.org/10.1093/ndt/gfm828

    Article  CAS  PubMed  Google Scholar 

  16. Muraira-Cárdenas LC, Barrios-Pérez M (2016) Effect of metabolic uncontrolled diabetes mellitus (DM) on the resistance index of renal (IR) Interlobar arteries assessed with pulsed Doppler. Gac Med Mex 152:213–217

    PubMed  Google Scholar 

  17. Milovanceva-Popovska M, Dzikova S (2007) Progression of diabetic nephropathy: value of intrarenal resistive index (RI). Prilozi 28:69–79

    CAS  PubMed  Google Scholar 

  18. Okten A, Dinç H, Kul M, Kaya G, Can G (1999) Renal duplex Doppler ultrasonography as a predictor of preclinical diabetic nephropathy in children. Acta Radiol 40:246–249. https://doi.org/10.3109/02841859909175549

    Article  CAS  PubMed  Google Scholar 

  19. Platt JF, Rubin JM, Ellis JH (1994) Diabetic nephropathy: evaluation with renal duplex Doppler US. Radiology 190:343–346. https://doi.org/10.1148/radiology.190.2.8284379

    Article  CAS  PubMed  Google Scholar 

  20. Brkljacić B, Mrzljak V, Drinković I, Soldo D, Sabljar-Matovinović M, Hebrang A (1994) Renalvascular resistance in diabetic nephropathy: duplex Doppler US evaluation. Radiology 192:549–554. https://doi.org/10.1148/radiology.192.2.8029430

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Baranak Safaeian or Hossein Zaeri.

Ethics declarations

Conflict of interest

The authors declared no conflict of interest.

Ethical approval

The study was in accordance with the ethical standards of the institutional research committee.

Informed consent

Informed consent was obtained from all participants in this study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nickavar, A., Safaeian, B., Zaeri, H. et al. Usefulness of Doppler ultrasound for the early diagnosis of diabetic nephropathy in type 1 diabetes mellitus. J Ultrasound 25, 79–82 (2022). https://doi.org/10.1007/s40477-021-00562-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40477-021-00562-2

Keywords

Navigation