Ultrasound Imaging in Assessment of Chronic Kidney Disease

The findings were published in the Journal of Ultrasound Medicine.The research team appraised the value of multiparametric quantitative ultrasound imaging in assessing chronic kidney disease compared to kidney biopsy pathologic findings as the reference standards.

The research team prospectively measured multiparametric quantitative ultrasound markers with grayscale, spectral Doppler, and acoustic radiation force impulse imaging in 25 patients with chronic kidney disease before kidney biopsy and 10 healthy volunteers. Based on all pathologic (glomerulosclerosis, interstitial fibrosis/tubular atrophy, arteriosclerosis, and edema) scores, the patients with chronic kidney disease were classified into mild and moderate to severe chronic kidney disease groups. Multiparametric quantitative ultrasound parameters included kidney length, cortical thickness, pixel intensity, parenchymal shear wave velocity, intrarenal artery peak systolic velocity, end-diastolic velocity, and resistive index. The research team tested the difference in quantitative ultrasound parameters among mild chronic kidney disease, moderate to severe chronic kidney disease, and healthy controls using analysis of variance, analyzed correlations of quantitative ultrasound parameters with pathologic scores and the estimated glomerular filtration rate using Pearson correlation coefficients, and examined the diagnostic performance of quantitative ultrasound parameters in determining moderate chronic kidney disease and an estimated glomerular filtration rate of less than 60 mL/min/1.73 m² using receiver operating characteristic curve analysis.

There were significant differences in cortical thickness, pixel intensity, peak systolic velocity, and end-diastolic velocity among the 3 groups. Moderate to good correlations were found for peak systolic velocity, end-diastolic velocity, and pixel intensity with pathologic scores and estimated glomerular filtration rate.

The authors concluded that peak systolic velocity, end-diastolic velocity, and pixel intensity are valuable in determining moderate to severe chronic kidney disease, but the value of shear wave velocity in assessing chronic kidney disease needs further investigation.

Gao, J., Perlman, A., Kalache, S., Berman, N., Seshan, S., Salvatore, S., Smith, L., Wehrli, N., Waldron, L., Kodali, H. and Chevalier, J. (2017), Multiparametric Quantitative Ultrasound Imaging in Assessment of Chronic Kidney Disease. J Ultrasound Med. doi:10.1002/jum.14209