Role of Renal Doppler and Shearwave Elastography in Diabetic Nephropathy

Diabetic nephropathy is a leading cause of chronic kidney disease and end-stage renal failure worldwide. Early detection of renal microvascular and parenchymal changes is crucial for timely intervention and risk stratification.

The objective is to evaluate the diagnostic utility of renal Doppler ultrasonography and shearwave elastography (SWE) in detecting and staging diabetic nephropathy, and to assess their correlation with biochemical markers of renal function.

This prospective cross-sectional study included adult patients with type 2 diabetes mellitus, categorized based on albuminuria stages. Renal resistive index and pulsatility index were measured using Doppler ultrasound, while renal cortical stiffness was quantified using point SWE. Findings were correlated with estimated glomerular filtration rate (eGFR), serum creatinine, and urinary albumin-creatinine ratio.

Increased renal cortical stiffness and elevated Doppler indices were observed in patients with microalbuminuria and overt nephropathy compared to normoalbuminuric diabetics. SWE showed a strong inverse correlation with eGFR and a positive correlation with urinary albumin levels. Combined use of Doppler and elastography improved early detection of subclinical nephropathy with high diagnostic sensitivity.

Renal Doppler and SWE are valuable non-invasive tools for early identification and functional assessment of diabetic nephropathy. Their integration into routine screening may enhance early detection, staging, and monitoring of renal involvement in diabetic patients.