Comparison of Renal Doppler Indices in Normal Kidney and in Diabetic Nephropath

Authors

  • Aimen Luqman Department of Radiology, Combined Military Hospital Multan/National University of Medical Sciences (NUMS) Pakistan
  • Maryam Iqbal Department of Radiology, Combined Military Hospital Multan/National University of Medical Sciences (NUMS) Pakistan
  • Hussain Rashid Ihsan Department of Radiology, Combined Military Hospital Multan/National University of Medical Sciences (NUMS) Pakistan
  • Atif Latif Department of Radiology, Combined Military Hospital Multan/National University of Medical Sciences (NUMS) Pakistan
  • Nosheen Sadiq Department of Radiology, Combined Military Hospital Multan/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76i5.13983

Keywords:

Diabetes Mellitus, Diabetic Nephropathy, Microalbuminuria, Renal-Aortic Ratio, Renal Indices, Renal Resistive Index.

Abstract

Objective: To assess and compare renal Doppler indices in normal and diabetic nephropathic kidneys to facilitate early diagnosis and intervention in diabetic nephropathy.

Study Design: Comparative Cross-sectional Study.

Place and Duration of Study: Department of Radiology, Combined Military Hospital, Multan Pakistan, from Jan to Sept 2025.

Methodology: Patients within the age range of 35 to 70 years with diagnosed diabetes mellitus for at least 10 years, referred for renal ultrasound as well as non-diabetic, normotensive patients of same age serving as controls were included in study. All individual were kept in two groups in a 2:1 ratio with Diabetic patients in Group-A, while non-diabetic, normotensive in Group-B (controls). Resistive Index (RI) and Renal-Aortic Ratio (R-AR) were recorded by Doppler ultrasound in both groups. ROC curve calculated with AUC value for differentiating diabetic Nephropathic kidney from normal kidney using RI and R-Ar as measures of diagnostic accuracy.

Results: Two hundred and forty six patients participated in this study, comprising 164 patients with diabetes and 82 non-diabetic patients with median age of 56.00(15.00) and 53.50(17.00) years respectively (p=0.162). Diabetic patients had significantly higher RI median 0.71(0.17) compared to control group 0.54(0.09) (p<0.001). Similarly, R-Ar was significantly elevated in diabetic patients 3.45(0.48) compared to controls 3.11(0.60) (p<0.001). The optimal RI cut-off value 0.635 provided sensitivity (72.6%), specificity (90.2%), PPV (93.7%), and NPV of 62.2%. The optimal R-AR cut-off 3.215, demonstrated sensitivity (79.9%), specificity (72.2%), PPV (85.1%), and NPV (64.1%).

Conclusion: Overall results indicated renal Doppler indices were significantly elevated in diabetic patient

Downloads

Download data is not yet available.

References

1. Azeem S, Khan U, Liaquat A. The increasing rate of diabetes in Pakistan: A silent killer. Ann Med Surg 2022; 79: 103901.

https://journals.lww.com/10.1016/j.amsu.2022.103901

2. Selby NM, Taal MW. An updated overview of diabetic nephropathy: Diagnosis, prognosis, treatment goals and latest guidelines. Diabetes Obes Metab 2020; 22(S1): 3–15.

https://doi.org/10.1111/dom.14007

3. Hussain S, Chand Jamali M, Habib A, Hussain MS, Akhtar M, Najmi AK. Diabetic kidney disease: An overview of prevalence, risk factors, and biomarkers. Clin Epidemiol Glob Health 2021; 9: 2–6. https://doi.org/10.1016/j.cegh.2020.05.016

4. Ceccarelli Ceccarelli D, Paleari R, Solerte B, Mosca A. Re-thinking diabetic nephropathy: Microalbuminuria is just a piece of the diagnostic puzzle. Clin Chim Acta 2022; 524: 146–153.

https://doi.org/10.1016/j.cca.2021.11.009

5. Sistani SS, Alidadi A, Moghadam AA, Mohamadnezhad F, Ghahderijani BH. Comparison of renal arterial resistive index in type 2 diabetic nephropathy stage 0-4. Eur J Transl Myol 2019; 29(4): 8364-8366.

https://doi.org/10.4081/or.2019.8364

6. Ali N, Khalaf-Awad AM, Hm F, Hashim AEA, Abd ElRazik GM. Role of Renal Resistive Index in early detection of Diabetic Nephropathy in Type II Diabetic Patients. SVU-Int J Med Sci 2024; 7(1): 1011–1021.

https://doi.org/10.21608/svuijm.2023.236371.1700

7. Maksoud AAA, Sharara SM, Nanda A, Khouzam RN. The renal resistive index as a new complementary tool to predict microvascular diabetic complications in children and adolescents: a groundbreaking finding. Ann Transl Med 2019; 7(17): 422–422. http://dx.doi.org/10.21037/atm.2019.08.65

8. K.C. T, Das SK, Shetty MS. Renal Resistive Index: Revisited. Cureus 2023; 15(3): e36091.

https://doi.org/10.7759/cureus.36091

9. Majos M, Polguj M, Stefańczyk L, Derlatka-Kochel M, Wachowski M, Majos A. Renal-aortic ratio as an objective measure of renal artery diameter a computed tomography angiography study. BMC Cardiovasc Disord 2019; 19(1): 181.

https://doi.org/10.1186/s12872-019-1163-7

10. Li H, Shen Y, Yu Z, Huang Y, He T, Xiao T, et al. Potential Role of the Renal Arterial Resistance Index in the Differential Diagnosis of Diabetic Kidney Disease. Front Endocrinol 2022; 12: 731187. https://doi.org/10.3389/fendo.2021.731187

11. Olanrewaju Jinadu Y, Raheem Raji Y, Oluwole Ajayi S, Lawal Salako B, Arije A, Kadiri S. Resistivity index in the diagnosis and assessment of loss of renal function in diabetic nephropathy. Cardiovasc J Afr 2022; 33(1): 28–34.

https://doi.org/10.5830/CVJA-2021-032

12. Afsar B, Elsurer R. Increased renal resistive index in type 2 diabetes: Clinical relevance, mechanisms and future directions. Diabetes Metab Syndr Clin Res Rev 2017; 11(4): 291–296. https://doi.org/10.1016/j.dsx.2016.08.019

13. Khairallah MK, Sobh MA, Mansour E, Ibrahim R, Mostafa MH. Renal Resistive Index as a Promising Tool in Early Identification of Diabetic Nephropathy. Egypt J Hosp Med 2023; 90(1): 1983–1987. https://doi.org/10.21608/ejhm.2023.284774

14. Abd El Dayem SM, El Bohy AEM, Hamed M, Ahmed S. Follow Up of Value of the Intrarenal Resistivity Indices and Different Renal Biomarkers for Early Identification of Diabetic Nephropathy in Type 1 Diabetic Patients. Open Access Maced J Med Sci 2017; 5(2): 188–192.

https://doi.org/10.3889/oamjms.2017.034

15. Cardoso CRL, Leite NC, Salles GC, Ferreira MT, Salles GF. Aortic stiffness and ambulatory blood pressure as predictors of diabetic kidney disease: a competing risks analysis from the Rio de Janeiro Type 2 Diabetes Cohort Study. Diabetologia 2018; 61(2): 455–665. https://doi.org/10.1007/s00125-017-4484-z

16. Vollema EM, Prihadi EA, Ng ACT, Gegenava T, Ajmone Marsan N, Bax JJ, et al. Prognostic Implications of Renal Dysfunction in Patients With Aortic Stenosis. Am J Cardiol 2020; 125(7): 1108–1110. https://doi.org/1016/j.amjcard.2019.12.040

17. Nasir M, Maryam S, Qadir SA, Fatima M. Correlation Between Renal Artery Resistive Index and Renal Function Tests in Type II Diabetic Patients. Avicenna J Health Sci 2024; 1(3): 62-66.

18. Christofides EA, Desai N. Optimal Early Diagnosis and Monitoring of Diabetic Kidney Disease in Type 2 Diabetes Mellitus: Addressing the Barriers to Albuminuria Testing. J Prim Care Community Health 2021; 12.

https://doi.org/10.1177/21501327211003683

19. Levey A, Inker L. Assessment of Glomerular Filtration Rate in Health and Disease: A State of the Art Review. Clin Pharmacol Ther 2017; 102(3): 405–419.

https://doi.org/10.1002/cpt.729

20. Darabont R, Mihalcea D, Vinereanu D. Current Insights into the Significance of the Renal Resistive Index in Kidney and Cardiovascular Disease. Diagnostics 2023; 13(10): 1687-1689.

https://doi.org/10.3390/ diagnostics13101687

Downloads

Published

30-09-2026

Issue

Section

Original Articles

Categories

How to Cite

1.
Aimen Luqman, Maryam Iqbal, Ihsan HR, Atif Latif, Nosheen Sadiq. Comparison of Renal Doppler Indices in Normal Kidney and in Diabetic Nephropath. Pak Armed Forces Med J [Internet]. 2026 Sep. 30 [cited 2026 Sep. 30];76(5):699-704. Available from: https://www.pafmj.org/PAFMJ/article/view/13983