Renal cortical stiffness is markedly increased in pre-diabetes mellitus and associated with albuminuria.
- Author:
Hilmi Erdem SUMBUL
1
;
Ayse Selcan KOC
2
;
Erdinç GÜLÜMSEK
1
Author Information
- Publication Type:Journal Article
- Keywords: albuminuria; cortical stiffness; diabetes mellitus; microvascular complications; pre-DM
- From:Singapore medical journal 2020;61(8):435-442
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTION:We aimed to investigate changes in renal cortical stiffness (CS) in Type 2 diabetes mellitus (DM) and pre-DM patients compared to subjects with normal glucose metabolism (NGM), as well as the usefulness of renal CS to determine the presence of nephropathy.
METHODS:This study included 125 individuals with NGM, pre-DM and Type 2 DM. Routine laboratory data was obtained, and micro- and macrovascular involvement were investigated. Urinary albumin-creatinine ratio (UACR) was measured for urinary albuminuria detection. In addition to routine renal ultrasonography, CS was measured using renal elastography.
RESULTS:Among the included patients, 42, 40 and 43 patients had NGM, pre-DM and Type 2 DM, respectively, with prevalence of nephropathy of 5%, 15% and 33%, respectively. Carotid and aortic intima-media thickness (IMT), renal width, and CS were found to be higher in the pre-DM and Type 2 DM groups than the NGM group. Aortic IMT, renal width and UACR levels were independently associated with CS. Patients with nephropathy were found to have a higher CS value than those without nephropathy (8.72 ± 1.67 kPa vs. 10.60 ± 1.74 kPa, p = 0.001). In receiver operating characteristic curve analysis, when the cut-off value for CS was taken as 9.2 kPa, renal CS predicted the possibility of nephropathy with 78.9% sensitivity and 71.4% specificity.
CONCLUSION:CS values are significantly higher in patients with impaired glucose metabolism. We recommend CS measurement as part of routine screening of nephropathy in patients with pre-DM and newly diagnosed Type 2 DM.
