ROLE OF INTRARENAL RESISTIVITY INDEX BY DUPLEX ULTRASONOGRAPHY IN DIABETIC NEPHROPATHY AND ITS CLINICO BIOCHEMICAL CORRELATION

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Dr. Basanta Swain Manjari
Dr. Madhumita Debata

Keywords

Diabetic nephropathy, color Doppler, ultrasound, intrarenal resistivity index.

Abstract

Diabetic nephropathy is among the common causes of end stage renal disease. Conventional ultrasound and colour Doppler provide easily available, affordable noninvasive follow up method for evaluation of kidneys in diabetic nephropathy. In diabetic nephropathy, the glomerulosclerosis and interstitial fibrosis causes alteration in intrarenal hemodynamics causing raised intrarenal vascular resistance reflected by increased intrarenal resistivity index (IRI).

The aim of the study is to evaluate intrarenal resistivity index by duplex ultrasonography in diabetic nephropathy patients and correlating them with clinical and biochemical parameters.

This was a cross sectional study carried out over 2 years period from September 2013 to September 2015.Patients of Type 2 diabetes as per WHO criteria having nephropathy were included.

A total of 96 patients of diabetic nephropathy were studied and divided into two groups based on  IRI.Group I (n=54) with IRI > 0.70 and group II (n=42) with IRI ≤ 0.70. Group I patients had significantly higher mean age and mean duration of diabetes compared to group II. Group I patients also had higher blood urea and serum creatinine 3.91 ± 1.63 vs 1.34 ± 0.85 mg/dl) compared to group II. Around 83.33 % patients in group II were in early stage of nephropathy where as 85.18 % in group I were in established stage of nephropathy. Among the complications of diabetes, presence of retinopathy correlates well with advanced diabetic nephropathy (IRI>0.70).

Intrarenal resistivity index (IRI) by duplex USG is a non-invasive parameter that can be correlated with clinico biochemical parameters of diabetic renal dysfunction and hence can be used as a prognostic indicator in follow up of diabetic nephropathy.

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