Doppler ultrasound of kidney interlobar arteries in different nephropaties

Aim: To study intrarenal Doppler parameters in medical nephropaties and to compare them with a control group. Intrarenal arteries reflect the parenchimal hemodynamics wich is affected in diabetes, hypertension and chronic renal failure.

Method: Four groups of patients sex and age matched, where examined with kidney Doppler Duplex ultrasonography: 25 patients in the diabetic group, 25 patients in hypertension group, 25 patients with chronic renal failure caused by glomerulopathies other than diabetes or hypertension and 25 patients in the control group. Kidney volume, resistivity index RI, pulsatility index PI and maximum systolic velocities (Vmax) where measured in both kidneys at three levels and medium values where calculated for each parameter. The values where compared between groups using student's T test. RI, PI and Vmax were corelated with kidney volumes using Pearson coefficient.

Results: Mean values for volumes, RI, PI and V max were: 113±23ml; 0.65±0.04; 0.98±0.1; 0.46±0.15cm/s for the control group, 128±46ml; 0.7±0.06; 1.28±0.22; 0.38±0.11cm/s for the diabetic group, 100±31ml; 0.67±0.06; 1.1±0.22; 0.54±0.2cm/s for the hypertensive group and 99.5±29ml; 0.71±0.01; 1.31±0.13; 0.24±0.05cm/s for the renal failure group. Values of kidney volumes were significantly higher in diabetic group (p<0.05). Values of RI and PI were higher in diabetic and renal failure group (p=0.04, p<0.005) comparing with control and hypertension group. RI and PI correlated significantly with kidney volumes (Pearson coef=0.44 and 0.48) in the diabetic group but not in other groups. In hypertension group Vmax had higher values that in all other groups.

Conclusion: RI and PI are important parameters for the evaluation of intrarenal haemodynamics with highest values in diabetics and renal failure. Highest velocities were in hypertension anf highest volumes were in diabetics.

Fig.1: Normal Doppler image of the kidney arteries

Fig.2: Doppler Duplex examination of an interlobar artery in a diabetic patient

Fig.3: Doppler Duplex view of AIL in a hypertensive patient

Fig.4: Kidney failure – Doppler duplex view of interlobar artery