Nomogram based on high-frequency shear wave elastography (SWE) to evaluate chronic changes after kidney...

Area of Science:

• Nephrology
• Radiology
• Transplantation Medicine

Background:

• Chronic changes in renal allografts are a major cause of graft dysfunction.
• Accurate assessment of chronic allograft changes is crucial for patient management.
• Noninvasive methods are needed to complement traditional biopsy procedures.

Purpose of the Study:

• To develop and validate a nomogram using high-frequency shear wave elastography (SWE) for noninvasive assessment of chronic changes in renal allografts.
• To establish SWE cutoff values for differentiating mild, moderate, and severe chronic changes.
• To identify independent predictors of moderate to severe chronic changes.

Main Methods:

• A total of 191 renal transplant patients were included.
• High-frequency SWE and conventional ultrasound were performed, followed by biopsy.
• Multivariate logistic analysis was used to develop a nomogram based on significant diagnostic factors.

Main Results:

• SWE showed good performance in differentiating chronic changes (AUC=0.870).
• Key predictors for moderate to severe changes included time since transplantation, proteinuria, GFR, echogenicity, and SWE.
• The developed nomogram demonstrated high accuracy (AUCs of 0.905 and 0.938 in training and validation groups, respectively).

Conclusions:

• The SWE-based nomogram is an accurate and applicable tool for evaluating chronic changes in renal allografts.
• Chronic changes in kidney transplantation correlate significantly with cortical stiffness.
• SWE offers a valuable noninvasive method for assessing allograft status.