Quantitative Assessment of Renal Stiffness Using Shear Wave Elastography for Pathological Staging in Chronic...

To evaluate the clinical utility of shear wave elastography (SWE) for quantifying renal stiffness in chronic nephritis syndrome (CNS) and correlate it with histopathological staging. A study involving 95 CNS patients and 95 healthy controls was conducted with ethical approval. All participants underwent bilateral renal SWE to measure cortical stiffness (Young's modulus, YM). CNS patients underwent ultrasound-guided renal biopsies. Estimated glomerular filtration rate (eGFR) and serum creatinine were also assessed. ANOVA, ROC curves, and Spearman's rank correlation were used for statistical analysis. Significant differences (p < 0.001) in bilateral renal YM Emax, Emean, and Emin values were observed between CNS and control groups, with CNS patients exhibiting higher values. ROC analysis indicated that bilateral renal YM Emax (AUC = 0.94), YM Emean (AUC = 0.86), and YM Emin (AUC = 0.90) were significant predictors of CNS. The pathological type of CNS significantly influenced bilateral renal YM Emin (p = 0.044), with SLE exhibiting lower values. Subgroup analysis by eGFR stage revealed significant differences in all YM parameters across stages (p < 0.05), with advanced stages (4-5) showing the highest mean values. Spearman's correlation showed positive correlations between YM parameters and serum creatinine, 24-hour urine protein excretion, and cystatin C (p < 0.01 or p < 0.05), and negative correlations with eGFR (p < 0.01). SWE is a non-invasive tool for assessing renal stiffness and damage in the CNS by measuring Young's modulus. Increased SWE-derived renal elastic modulus values correlate with the progression of renal fibrosis in CNS patients.