RENAL DUPLEX ULTRASOUND EVALUATION OF TYPE DIABETIC 2 PATIENTS

Objective-The objective of the research is to evaluate the renal volume and intrarenal hemodynamics in a group of diabetic patients with normal renal function, in comparison with non diabetic controls, using ultrasound with Doppler. Methods-The renal volume and the resistive index (RI) of segmental arteries were assessed by using Doppler ultrasonography in 88 diabetic patients (44 males, 44 females, median age 58 years (37-28 69)) and 73 non diabetic controls (48 males, 25 females, median age years 53(27-75)) without renal artery stenosis. Results-Both renal volume and RI values in diabetics were significantly higher compared to that of controls (Volume: Diabetic patients 197.3±47.6 ml. Controls 162.5±35.2 ml. P<0.0001; RI: Diabetic patients 0.70±0.05, Controls 0.59±0.06 <0.0001). Renal hypertrophy was present even in diabetic patients without proteinuria (Mean renal volume in patients without proteinuria 198.3±45.9 ml, controls 162.5±35.2 ml. P<0.005). Patients with higher RI showed a significantly greater proteinuria (RI<0.75: 15.9 mg/g (4.2-1718.9); RI>0.75: 37.9 mg/g (11.34-2087.0); P<0.02). Conclusions-Changes in renal volume and hemodynamics are detectable with ultrasound imaging in diabetic patients. Those changes are also present in patients without proteinuria or signs of renal atherosclerosis and with both normal and increased glomerular filtration rate. These results indicate a potential role of ultrasound with Doppler in the early identification of morphologic and hemodynamic renal changes in type 2 diabetic patients.