SONOGRAPHIC ASSESSMENT OF RENAL SIZES, PARENCHYMAL THICKNESS AND VOLUMES IN PATIENTS WITH TYPE-2 DIABETES MELLITUS
Abstract
Background: Ultrasonography can give real time assessment of the kidneys; yet its utility in the evaluation of renal changes during diabetes mellitus illness is rarely reported in Nigeria despite the high burden of diabetes related kidney damage. Methodology: In this case control study, renal sizes, parenchymal thickness and volume of kidneys of 101 healthy adults and 119 cases with type 2 diabetes mellitus measured by ultrasound during their routine clinic days were compared. All the diabetes cases have normal renal function as measured by their urea and creatinine level.
Results: Mean age of adults with type 2 diabetes mellitus (53.81 ± 10.80 years) and control (41.15 ± 13.91years) groups were significantly different (p < 0.05). Statistical analysis (independent sample T-test) showed significant increase in mean renal width, parenchymal thickness and volume of type 2 diabetes mellitus patients with normal renal function compared to control group (p< 0.05) on the right and left kidney. There was no significant difference in mean renal length and antero-posterior diameter between the two diabetic groups. Conclusion: There was a marginal increase in renal width, parenchymal thickness and volume in type 2 diabetes mellitus patients with normal renal function. Ultrasonography therefore provides useful information in detecting renal changes in individuals with type 2 diabetes mellitus.
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Pradeep KD. Renal function in diabetic nephropathy. World J Diabetes 2010; 1; 48-56
Ala M, Abd E, Osman H, Elzaki A, Elrahim E. Ultrasonographic renal size in individuals with known diabetes mellitus. Sch J app med sci 2013; 1: 690-92.
Sunny C, Ekene Y. State of diabetes care in Nigeria: A Review. Nig Health J 2011; 11: 101-06.
Valeriya L, Markku L. Genetic screening for the risk of type 2 diabetes. Diab car 2013; 36: 5120-26.
Mauer SM, Steffes MW, Brown DM. The kidney in diabetes. Ame J Med 1981; 70: 603–12.
Reeves WB, Andreoli TE. Transforming growth factor b contributes to progressive diabetic nephropathy. Proc Nat Acad Sci 2000; 97: 7667-69.
Mauer S, Steffes M, Ellis E, Sutherland D, Brown D, Goetz F. Renal interstitial expansion in insulin-dependent diabetes mellitus. J Clin Inves 1984; 74: 1143–55.
Ueno M, Kawashima S, Nihsi S, Shimada S, Shimada N, Karasawa R, et al. Tubulointerstitial lesions in non-insulin dependent diabetes mellitus. Kid Inter 1997; 52: 191– 4.
Hostetter T H, Troy J L, Brenner BM. Glomerular hemodynamics in experimental diabetes mellitus. Kid Inter 1981; 19: 410–15.
Mogensen CE. Early glomerular filtration in insulin-dependent diabetes and late nephropathy. Scand J Clin Lab Invest 1986; 46: 201-6.
Premaratne E, McIsaac RJ, Tsalamandris C, Panagiotopoulos S, Smith T, Jerums G. Renal hyperfiltration in type 2 diabetes: effect of age-related decline in glomerular filtration rate. Diab 2005; 48: 2486-93.
Kleinman KS, Fine LG. Prognostic implications of renal hypertrophy in diabetes mellitus. Diab Metab Rev 1988; 4: 179-89.
Fioretto P, Caramori ML, Mauer M. The kidney in diabetes: dynamic pathways of injury and repair. Diab 2008; 51: 1347-55.
Vincent R, Magalie G, Catherine L, François L, Michel M, Christelle R, et al. Large kidneys predict poor renal outcome in subjects with diabetes and chronic kidney disease. Nephrol 2010; 11: 1471-2369.
Ibrahim H, Mondress M, Tello A, Fan Y, Koopmeiners J, Thomas W. An Alternative formula to the Cockcroft-Gault and the modification of diet in renal diseases formulas in predicting GFR in individuals with type 1 diabetes. J Am Soc Nephrol 2005; 16: 1051-60.
Chudleigh RA, Dunseath G, Evans W, Harvey JN, Evans P, Ollerton R, et al. How reliable is estimation of glomerular filtration rate at diagnosis of type 2 diabetes?. Diab Car 2007; 30: 300-5.
Saddig D J, Naglaa M A, Ibrahim AA, Hashim R F, Hammad H E. Evaluation of Renal Disorders in Type 2 Diabetic Patients Using Ultrasonography. J Med Imag 2013; 3: 165-170
Bakker J, Olree M, Kaatee R, de Lange EE, Moons KG, Beutler JJ, et al. Renal volume measurements: accuracy and repeatability of US compared with that of MR imaging. Radiol 1999; 211: 623–28.
Cheong B, Muthupillai R, Rubin MF, Flamm SD. Normal values for renal Length and volume as measured by magnetic resonance imaging. Clin J Am Soc Nephrol 2007; 2: 38–45.
Omolola M A, Adebola E O, Ademola J A, Olusegun O A. Ultrasonographic renal sizes, cortical thickness and volume in Nigerian children with acute falciparum malaria. Mal J 2013; 12: 1475-2875.
Sugam S, Prajwal R, Bibek P, Manoy S, Prashant R, Manorayan S, Binod K. Serum urea and Creatinine in Diabetic and Non diabetic subjects. J Nep Assoc Med Lab Sci 2008; 1: 11-12.
Roger, C.S. Clinical Sonography - A practical guide. 3rd ed. Lippincott: Williams and Wilkins: 1998.
Zeb S, Waseem M, Raza S, Adil S, Iffat Y. Sonographic measurement of renal dimensions in adults and its correlates. Inter J Res Med Pub Health, 2012; 4: 1-16.
Elkin M. Kidney Size – Radiology of the urinary system. Boston: Little Brown and Company: 1980; 1014 – 1032.
Tuttle K, Bruton J, Perusek M. Effect of strict acids and renal haemodynamic response to amino acids and renal enlargement in insulin dependent diabetes mellitus. Eng J med 1991; 324:1126.
Radermacher J. Ultrasonography of the kidney and renal vessels. Normal findings, inherited and parenchymal diseases. Urol 2005; 44 : 1351-63.
Agarwal AK, Sumeet S, Umesh G, Rajbala Y, Sanjem M, Arun J. Glomerular filtration rate and total kidney volume in cases of recent Type 2 Diabetes Mellitus. J Ind Acad Clin Med 2005; 6 : 285 – 90.
Christiansen JS, Gammelgaard J, Trower B, Frandseen M, Urskor H, Parving HH. Kidney function and size in diabetics before and during initial insulin treatment. Kid inter 1981; 20: 451 – 56.
Gragnoli G, Sinnoriri A, Tanganelli I, Fondelli C, Bargogni P, Borgogni L, et al. Prevalence of glomerular hyperfiltration and nephromegaly in normo and microalbuminuric type 2 diabetic patients. Nephro 1993; 65: 206 – 211.
Wirta O, Pastenack A, Laippala P. Glomerular Filtration Rate and kidney size after six years disease duration in non insulin – dependent diabetic subjects. Clin nephrol 1996; 45: 10 -17.
Heptinstall RH. Pathology of the kidney. Boston; Little Brown and Company. 1996: 466.
Schuntz A, Hanseen H, Christiansen T. Kidney function in newly diagnosed type 2 (non insulin dependent) diabetic patients, before and during treatment. Diab 1982, 21: 683 – 88.
Ruggenenti P, Remuzzi G. Nephropathy of type 1 and type 2 diabetes: diverse pathophysiology, some treatment? Nephrol Dial Transplant 2000; 15: 1900 – 02.
Christensen P, Larsen S, Horn T. Causes of albuminuria in patients with type 2 diabetes without diabetic retinopathy. Kid inter 2000; 58: 1719 -31.
Inomota S. Renal hypertrophy as a prognostic index for the progression of diabetic renal disease in non insulin dependent diabetes mellitus. J diab compl 1993; 7: 28–33.
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