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Renal histomorphometry and resistance index in children with renal disease
M Türkmen1, S Kavukçu, S Sarioğlu
1Department of Pediatrics, Dokuz Eylül University, Medical Faculty, 35340, Inciralti, Izmir, Turkey.
Insights
The renal resistance index (RI) correlates with kidney structure in children with severe fibrosis, aiding in monitoring disease progression. This finding is crucial for understanding pediatric kidney disease and its management.
Area of Science:
- Pediatric Nephrology
- Medical Imaging
- Renal Pathology
Background:
- Glomerular and nonglomerular renal diseases affect children, necessitating accurate diagnostic and monitoring tools.
- The renal resistance index (RI), assessed via ultrasound, is a non-invasive measure of renal vasculature.
- Histomorphometric analysis provides detailed structural information from kidney biopsies.
Purpose of the Study:
- To investigate the relationship between the renal resistance index (RI) and histomorphometric parameters in pediatric patients with kidney disease.
- To determine if RI can serve as a surrogate marker for structural changes in the kidneys of children.
Main Methods:
- Retrospective analysis of 30 pediatric patients with glomerular or nonglomerular renal disease.
- Evaluation of kidney biopsy specimens for glomerular surface density, glomeruli number, capillary density, capillary number within glomeruli, and afferent arteriole diameter.
- Correlation of these histomorphometric variables with renal resistance index (RI) measurements from ultrasound.
Main Results:
- The RI showed a negative correlation with age in younger children (2.5-4.0 years).
- RI was positively correlated with serum creatinine levels and differed significantly between normal and elevated levels.
- In patients with severe interstitial fibrosis, RI was negatively correlated with glomeruli number, glomerular surface density, capillary number, and afferent arteriole diameter.
Conclusions:
- The renal resistance index (RI) is associated with specific histomorphometric variables in children with severe renal fibrosis.
- RI may be a valuable tool for monitoring disease progression and structural changes in pediatric kidney disease, particularly in cases of severe fibrosis.
Purpose:
The aim of this study was to examine the relationships between the renal resistance index (RI) and histomorphometric variables measured in children with glomerular or nonglomerular renal disease. Patients and Methods The medical records, sonography reports, and biopsy specimens of 30 children with glomerular or nonglomerular renal disease (mean age, 11.0 +/- 4.7 years; range, 2. 5-17 years) who underwent sonographic evaluation and biopsy of the right kidney were retrospectively studied. Biopsy specimens were evaluated for glomerular surface density, number of glomeruli in the stroma, capillary surface density, number of capillaries within the glomeruli, and the diameters of the afferent arterioles.
Results:
The RI was negatively correlated with age in patients 2.5-4.0 years old (rho = -1.0, p < 0.001). The RI was positively correlated with serum creatinine levels (rho = 0.63, p < 0.001), and the RI differed significantly between patients with abnormally high and age-appropriate serum creatinine levels (0.8 +/- 0.1 and 0.6 +/- 0.1, respectively; p = 0.002). No differences in age, histomorphometric variables, RI, or arteriolar diameter were found between patients who had interstitial fibrosis and those who did not, and the RI was not correlated with histomorphometric variables in either group. However, the mean RI was significantly higher in patients with severe fibrosis than in those with mild fibrosis. In those with severe fibrosis, the RI was negatively correlated with number of glomeruli in the stroma (rho = -0.975, p < 0.01), glomerular surface density (rho = -0.931, p < 0.05), number of capillaries within the glomeruli (rho = -0.989, p < 0.01), and arteriolar diameter (rho = -1.00, p < 0.01).
Conclusions:
The RI was correlated with histomorphometric variables in patients with severe interstitial fibrosis and could be useful in the follow-up of these patients.