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The pattern of renal artery Doppler indices in patients with sickle cell disease
Vivek Patre1, Nobal Chandrakar1
1Radiodiagnosis, Pt. J. N. M. Medical College and Associated Dr. B. R. Ambedkar Memorial Hospital, Raipur (Chhattisgarh), India.
Insights
Renal artery Doppler indices, including pulsatility and resistive indices, are significantly elevated in sickle cell disease patients without kidney impairment, serving as early predictors of vascular changes.
Area of Science:
- Nephrology
- Radiology
- Hematology
Background:
- Sickle cell disease (SCD) is a genetic blood disorder that can lead to various organ complications, including kidney disease.
- Early detection of renal involvement in SCD is crucial for timely intervention and management.
- Renal artery Doppler indices may offer non-invasive insights into vascular health in SCD patients.
Purpose of the Study:
- To investigate the pattern of renal artery Doppler indices in patients with sickle cell disease (SCD) who exhibit no laboratory evidence of renal impairment.
- To determine if Doppler indices can serve as early indicators of renal vascular changes in SCD.
Main Methods:
- A case-control study involving 50 patients with SCD (HbSS phenotype) and 50 healthy controls.
- All participants underwent ultrasound and color Doppler examinations of the kidneys.
- Pulsatility index (PI) and resistive index (RI) of the main renal artery, segmental artery, and interlobar artery were measured and compared between groups.
Main Results:
- Patients with SCD showed significantly higher PI and RI in the main renal artery, segmental artery, and interlobar artery compared to controls (p <0.0001 for all).
- Optimal cut-off values were identified: PI >1.08 (72% sensitivity, 88% specificity) and RI >0.635 (66% sensitivity, 98% specificity).
Conclusions:
- Elevated renal artery PI and RI in SCD patients without overt renal impairment suggest subclinical vascular changes.
- Renal Doppler sonography indices can act as early radiologic predictors of renal vascular alterations in sickle cell disease.
- These findings highlight the potential of Doppler ultrasound for monitoring renal health in SCD patients.
Aim:
To evaluate the pattern of renal artery Doppler indices in patients with sickle cell disease who do not have laboratory evidence of renal impairment.
Material And Methods:
A case-control study was carried out after enrolling 50 patients with sickle cell disease (HbSS phenotype) (sickle cell disease group) and 50 control subjects (control group). All the participants underwent ultrasound and color Doppler examination, and the pulsatility index and resistive index values of the main renal artery, segmental artery, and interlobar artery in both kidneys were recorded and compared.
Results:
The Doppler measurements of the main renal artery, segmental artery, and interlobar artery were compared between the control and sickle cell disease groups. It was found that both pulsatility index and resistive index were significantly higher in the sickle cell disease group, as compared to the control group, for the main renal artery, segmental artery, and interlobar artery (p <0.0001, p <0.0001, and p <0.0001, respectively). The optimal cut-off points for mean pulsatility index and resistive index, as measured by the Youden index, were found to be >1.08 (72% sensitivity and 88% specificity) and >0.635 (66% sensitivity and 98% specificity), respectively.
Conclusions:
Resistive index and pulsatility index values in renal Doppler sonography can serve as early radiologic predictors of renal vascular changes in sickle cell disease patients who do not have laboratory evidence of renal impairment.
