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Shear-wave elastography in renal stiffness in children with hematuria and/or proteinuria
Xingyu Chen1, Xinxin Huang1, Xiuyun Li1
1Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Insights
Shear wave elastography (SWE) can detect renal stiffness changes in children with hematuria or proteinuria. This technique aids in the early identification of glomerular disease in pediatric patients with abnormal urinalysis results.
Area of Science:
- Pediatric Nephrology
- Medical Imaging
- Diagnostic Techniques
Background:
- Hematuria and proteinuria are common indicators of kidney disease in children.
- Early detection of renal abnormalities is crucial for effective management and preventing long-term complications.
- Assessing renal stiffness may provide novel insights into kidney health in pediatric patients.
Purpose of the Study:
- To evaluate renal stiffness in children with hematuria and/or proteinuria using shear wave elastography (SWE).
- To investigate the clinical value of renal stiffness measurements in pediatric patients with abnormal urinalysis.
- To correlate renal stiffness with clinical and laboratory parameters in children.
Main Methods:
- A cohort of 349 pediatric patients was divided into four groups: pure hematuria (HU), pure proteinuria (PU), concomitant hematuria and proteinuria (HUPU), and control (non-HUPU).
- Renal stiffness was assessed using shear wave elastography (SWE).
- Demographic data, laboratory results, and renal ultrasound findings were collected and analyzed.
Main Results:
- Significant differences in renal cortical/medullary elasticity were observed among the four groups.
- An interaction effect between hematuria and proteinuria on renal cortical stiffness was identified.
- Renal elasticity values showed correlations with various clinical parameters including sex, age, BMI, and 24-hour urinary protein quantity.
Conclusions:
- Shear wave elastography (SWE) is a viable tool for detecting renal stiffness alterations in children with hematuria and/or proteinuria.
- SWE demonstrates clinical utility in the early detection of glomerular disease in pediatric patients with abnormal urine tests.
- This non-invasive technique can aid in assessing early renal injury in children presenting with urinalysis abnormalities.
Background:
We sought to evaluate renal stiffness in children with hematuria and/or proteinuria using shear wave elastography (SWE) and to investigate the clinical value of renal stiffness in children with hematuria and/or proteinuria.
Methods:
According to the results of urinary occult blood and urinary protein tests, 349 pediatric patients were categorized into one of four groups: pure hematuria (HU), pure proteinuria (PU), concomitant hematuria and proteinuria (HUPU), or control (non-HUPU). Patient demographic data, laboratory test results, and renal ultrasound data were collected.
Results:
There were significant differences in cortical/medullary elasticity among the four groups (the most sensitive cutoff value between HU and PU was 1.72) (P < 0.05). We found that hematuria and proteinuria interacted with renal cortical elasticity (P < 0.05) but that hematuria and proteinuria did not interact with renal medullary elasticity or cortical/medullary elasticity (P > 0.05). Renal elasticity values correlated with sex, age, body surface area, body mass index, qualitative urinary protein, urine N-acetyl-β-D-glucosaminidase, 24-hour urinary protein quantity, renal volume, and renal cortical thickness (P < 0.05).
Conclusions:
SWE can be used to detect changes in renal stiffness in children with hematuria and/or proteinuria. SWE is beneficial for the early detection of glomerular disease in children with abnormal urine test results.
Impact:
This study evaluated the utility of shear wave elastography for the assessment of renal elasticity in pediatric patients presenting with hematuria and/or proteinuria. Children with pure proteinuria had significantly higher renal cortical/medullary elasticity values than those with pure hematuria. An interaction effect between hematuria and proteinuria on renal cortical stiffness was observed. Shear wave elastography can be used as a tool to assess early renal injury in children with urinalysis abnormalities.
