Objective To discuss the value of contrast-enhanced ultrasound(CEUS)parameters in evaluating the formation of Kimmelstiel-Wilson(K-W)nodules in diabetic nephropathy(DN).Methods Sixty-two patients pathologically diagnosed with DN and undergoing CEUS in the First Medical Center of Chinese PLA General Hospital from March 2017 to January 2020 were assigned into two groups according to whether K-W nodules were formed.The cortical CEUS parameters and the ratios of cortical to medullary CEUS parameters were compared between the two groups.Results The 62 patients included 19 patients without K-W nodules(group A)and 43 patients with K-W nodules(group B).The median rise time(
Contrast Media ; Diabetes Mellitus ; Diabetic Nephropathies/diagnostic imaging* ; Humans ; Ultrasonography

PURPOSE: Diabetes mellitus (DM) is the most common cause of end-stage renal disease (ESRD) and an important risk factor for cardiovascular (CV) disease. We investigated the impact of DM on subclinical CV damage by comprehensive screening protocol in ESRD patients. MATERIALS AND METHODS: Echocardiography, coronary computed tomography angiogram, 24-h ambulatory blood pressure monitoring, and central blood pressure with pulse wave velocity (PWV) were performed in 91 ESRD patients from the Cardiovascular and Metabolic disease Etiology Research Center-HIgh risk cohort. RESULTS: The DM group (n=38) had higher systolic blood pressure than the non-DM group (n=53), however, other clinical CV risk factors were not different between two groups. Central aortic systolic pressure (148.7±29.8 mm Hg vs. 133.7±27.0 mm Hg, p= 0.014), PWV (12.1±2.7 m/s vs. 9.4±2.1 m/s, p<0.001), and early mitral inflow to early mitral annulus velocity (16.7±6.4 vs. 13.7±5.9, p=0.026) were higher in the DM group. Although the prevalence of coronary artery disease (CAD) was not different between the DM and the non-DM group (95% vs. 84.4%, p=0.471), the severity of CAD was higher in the DM group (p=0.01). In multivariate regression analysis, DM was an independent determinant for central systolic pressure (p=0.011), PWV (p<0.001) and the prevalence of CAD (p=0.046). CONCLUSION: Diabetic ESRD patients have higher central systolic pressure and more advanced arteriosclerosis than the non-DM control group. These findings suggest that screening for subclinical CV damage may be helpful for diabetic ESRD patients.
Aged ; Aorta ; Biomarkers ; Blood Pressure/physiology ; Blood Pressure Monitoring, Ambulatory ; Coronary Artery Disease/diagnostic imaging/*physiopathology ; Diabetes Mellitus/*physiopathology ; Diabetic Nephropathies/physiopathology ; Echocardiography ; Female ; Humans ; Kidney Failure, Chronic/*physiopathology ; Male ; Middle Aged ; Pulse Wave Analysis ; Regression Analysis ; Risk Factors ; Systole/physiology

Arteriovenous Shunt, Surgical ; adverse effects ; Brachial Artery ; diagnostic imaging ; Diabetic Nephropathies ; complications ; therapy ; Hematoma ; complications ; diagnostic imaging ; Humans ; Magnetic Resonance Imaging ; Male ; Median Neuropathy ; diagnostic imaging ; etiology ; physiopathology ; Middle Aged ; Neural Conduction ; Renal Dialysis ; Ultrasonography

DSA(Digital Subtractin Angiography) is a valuable diagnostic imaging method in many clinical fields, includingranal-related conditons. Sixty four renal DSA examinations were performed in 59 patients with renal-relateddiseases from Jan. 1984 to Dec. 1985. Summary of these were as follows: 1. Intraarterial (IA)-DSA is performed in6 cases, intravenous(IV)-DSA in 58 cases. In 58 Examinations of IV-DSA, diagnostic image quality is obtained in 51cases(88%). 2. In investigations of a possible renovascular etiology of hypertension, IV-DSA,is a safe, sensitiveand accurate method. On screening for evaluation of renovascular hypertension, RSP should be replaced with IV-DSA,because IV-DSA is moe sensitive and accurate and can detect not only anatomic change of renal arttery but alsofunctional hemodynamic change. 3. IV-DSA is valuable in diseases with morphologic changes of vessels. Incharacterization of a known renal mass, and evaluation of hematuria, suspected aneurym and renal trauma, IV-DSA isvery useful diagnostic imaging modality. 4. In evaluation of potential renal donors, IV-DSA is an accurate andsafe method with 82.4% of accuracy. IV-DSA also is useful in follow-up of allograft recipients. 5. Ininvestigation of diabetic nephropathy, glomerulonephritis, pyelonephritis, IV-DSA is little helpful. 6. Theadvantages of DSA are well known, particularly post-procedure process using computer programs is helpful forobtaining informations of hemodynamic change or time-sequence-curve of density etc. More technical improvementwith this modality is required for improvement of the image quality and resolution. And more accumulation ofclinical experience is required in order to increase the diagnostic accuracy.
Allografts ; Angiography, Digital Subtraction ; Diabetic Nephropathies ; Diagnostic Imaging ; Follow-Up Studies ; Glomerulonephritis ; Hematuria ; Hemodynamics ; Humans ; Hypertension ; Hypertension, Renovascular ; Mass Screening ; Methods ; Pyelonephritis ; Tissue Donors