Evaluation of renal volume by ultrasonography in patients with essential hypertension in Ile-Ife, south western Nigeria

Renal cortex thickness and changes in renal function after transcatheter aortic valve implantation

BACKGROUND

The association between renal morphological findings and changes in renal function in patients undergoing transcatheter aortic valve implantation (TAVI) is unexplored.

AIMS

We aimed to investigate the association between renal morphological findings and changes in renal function in patients undergoing TAVI.

METHODS

Among 283 consecutive patients undergoing TAVI between 2018 and 2021, the study sample included 224 patients. Renal morphological measurements were performed by preoperative multidetector computed tomography. Estimated glomerular filtration rate (eGFR) improvement and deterioration were defined as positive or negative changes in an eGFR of ≥10% one month after TAVI. The renal cortex thickness index was defined as the ratio of total renal cortex thickness to body surface area.

RESULTS

The incidences of eGFR improvement and deterioration were 33.9% and 24.1%, respectively. The renal cortex thickness index had a significant correlation with changes in eGFR (r=0.34, p<0.01). The index of the area under the curve of renal cortex thickness for eGFR improvement and deterioration were 0.73 and 0.68, respectively. The cut-off values were 5.82 mm/m² for eGFR improvement (odds ratio [OR]: 0.10; 95% confidence interval: 0.05-0.20; p<0.01) and 4.89 mm/m² for eGFR deterioration (OR: 9.07; 95% confidence interval: 4.55-18.6; p<0.01).

CONCLUSIONS

The renal cortex thickness index was associated with changes in renal function in patients who underwent TAVI. Its measurements might be useful for predicting the renal function change in patients undergoing TAVI.

Variation of Ultrasonic Renal Volume between Hypertensive and Non-Hypertensive Individuals in Relation to Body Size Parameters

BACKGROUND

Estimation of renal size is vital for the diagnosis of abnormal structural change on the kidneys due to the adverse effects of chronic diseases like hypertension. This study evaluated renal volume by ultrasound in relation to body size parameters, notably body mass index (BMI) and body surface area(BSA) in hypertensive and non-hypertensive individuals.

METHODS

A hospital-based comparative cross-sectional study was conducted from February to September 2018 at the Radiology department of the Jimma University Medical Center (JUMC). The study included consecutively selected samples of 85 ambulatory hypertensive patients and 60non-hypertensive controls recruited consecutively on voluntary basis. After receiving verbal consent, each subject underwent abdominal ultrasound examination and length, width and thickness of both kidneys were measured and used for estimation of renal volume. The statistical evaluation included independent samples t-tests for mean differences with regard to ultrasonic renal measurements between hypertensive and non-hypertensive groups.

RESULTS

A total of 145 adults aged 16 - 80 years (mean ±SD=44 ±17) participated in the study. In the hypertensive group, mean renal volume of 97.7cm3 for the right kidney and104.4cm3 for the left kidney whereas in the control group, it was 101.1cm3 for the right and 111.8 cm3 for the left kidney. The mean right renal volume to BSA ratio was 58.2cm3/m2 in hypertensive group, while it was 62.6cm3/m2 among the control group (p=0.076). The mean left renal volume to BSA of the patients was 62.2cm3/m2 and significantly (p=0.012) lower than that of the non-hypertensive group, which was 69.3 cm3/m2.

CONCLUSION

Slightly smaller bilateral renal volume among hypertensive patients as compared the controls was obtained.

Sonographic Assessment of Renal Volume in Normotensive Pregnant Women and Women With Pregnancy-Induced Hypertension in Enugu Metropolis

Objective:

Renal volume (RV) assessment during obstetric sonography is rarely considered in our locality. Understanding the changes in RV in both normotensive pregnant (NP) and pregnancy-induced hypertensive (PIH) women is important in making correct diagnosis regarding pregnancy outcome. This study is aimed at determining the RV in NP and PIH women and correlating RV with fetal gestational age (FGA), body mass index (BMI), and parity in NP women.

Materials and Methods:

This cross-sectional study involved 450 patients recruited at a Tertiary Hospital. A pilot study was done to determine the interobserver variability in RV measurement. RV was calculated using the following formula: L × W × AP × 0.523. Parity, BMI, and blood pressure were documented, while FGA was calculated as an average of FGAs obtained from the measurements of fetal biometric parameters.

Results:

Mean RV of PIH women was significantly higher than that of NP women ( P < .05). RV shows a positive significant relationship with BMI and FGA, while it shows a negative relationship with parity in NP ( P < .05).

Conclusion:

Reference range values of RV were generated for clinical use in our locality, while there is statistically significant difference between RV in NP and PIH women.

Exploration of a Framework for the Identification of Chronic Kidney Disease Based on 2D Ultrasound Images: A Survey

BACKGROUND

Chronic kidney disease (CKD) is a fatal disease that ultimately results in kidney failure. The primary threat is the aetiology of CKD. Over the years, researchers have proposed various techniques and methods to detect and diagnose the disease. The conventional method of detecting CKD is the determination of the estimated glomerular filtration rate by measuring creatinine levels in blood or urine. Conventional methods for the detection and classification of CKD are tedious; therefore, several researchers have suggested various alternative methods. Recently, the research community has shown keen interest in developing methods for the early detection of this disease using imaging modalities such as ultrasound, magnetic resonance imaging, and computed tomography.

DISCUSSION

The study aimed to conduct a systematic review of various existing techniques for the detection and classification of different stages of CKD using 2D ultrasound imaging of the kidney. The review was confined to 2D ultrasound images alone, considering the feasibility of implementation even in underdeveloped countries because 2D ultrasound scans are more cost effective than other modalities. The techniques and experimentation in each work were thoroughly studied and discussed in this review.

CONCLUSION

This review displayed the cutting-age research, challenges, and possibilities of further research and development in the detection and classification of CKD.

Relationship between renal volume and atherosclerosis in nondiabetic hypertensive patients with normal glomerular filtration rate

Background: The association between cystatin C (CysC) and atherosclerosis has been shown in numerous studies in hypertensive patients and in various patient groups with high cardiovascular risk. The study examining the association between renal volume and atherosclerosis is very limited. This study aimed to investigate whether there is an association between the presence of atherosclerosis with CysC and renal volume in hypertensive patients.Methods: 133 hypertensive patients and 80 healthy volunteers were evaluated. CysC level was studied in the blood sample taken from all participants. Carotid intima media thickness (CIMT) and renal volume were measured with ultrasound always by the same radiologist. Laboratory findings, CysC, CIMT, and renal volume measurements of the groups were compared statistically.Results: There was no significant difference in mean renal volume values between hypertension and control groups. There was no significant correlation between renal volume with albuminuria and proteinuria. CIMT was significantly higher in hypertension group than in control group (p = .003). There was a significant correlation between renal volume and CIMT, which is an indicator of subclinical atherosclerosis (r = 0.213, p = .001). Renal volume was found to be an independent predictor of CIMT when corrected with variables such as age, BMI, serum LDL-cholesterol level, creatinine, CysC, and albumin-to-creatinine ratio.Conclusion: Ultrasonographic renal volume measurement, which is easy to perform and does not take a long time, can be a useful method for predicting the presence of atherosclerosis in hypertensive patients with GFR >60 ml/min.

Old habits die hard; does early urinary catheter removal affect kidney size, bacteriuria and UTI after renal transplantation?

Introduction: Renal transplantation is the treatment of choice in chronic renal failure patients. Objectives: The purpose of this study was to evaluate the impact of urinary catheter removal time on transplanted kidney size and incidence of asymptomatic bacteriuria and urinary tract infections (UTIs). Patients and Methods: This retrospective cohort study evaluated the clinical outcomes of 109 consecutive live donor renal transplant recipients from December 2011 to July 2014. Routine ultrasound examinations were performed on donor's kidney prior to operation and one month later. Kidney volume was calculated. UTI and bacteriuria were evaluated one month later. Patients were divided into two groups based on time of Foley catheter removal (before and after fifth day posttransplantation). Results: In this study 74 males (67.9%) and 35 females (32.1%) were evaluated. Sixty-six patients (57.92%) were in group 1. None of the patients with positive urine culture had UTI but bacteriuria occurred in all of them (21.1%). Bacteriuria time after transplantation and catheter removal was significantly later in group 1 and it was not different in female group but they were later in male group. The mean renal volume increase was positively correlated to renal transplant recipient and donor's age and donor's body mass index (BMI) (P<0.05). Conclusion: This study showed that the time of catheter removal after kidney transplantation does not affect incidence of UTI but increases the probability of bacteria in men whose catheter was removed within 5 days after transplantation. We also found that the renal volume change is not associated with catheter removal time and bacteriuria.

Maternal renal artery Doppler sonographic changes in pregnancy-induced hypertension in South West Nigeria

BACKGROUND

To evaluate the renal arterial hemodynamic changes caused by pregnancy-induced hypertension using Doppler ultrasonography.

MATERIALS AND METHODS

Eighty (80) subjects with pregnancy-induced hypertension (PIH) and 160 controls (80 pregnant normotensive women and 80 healthy, non-pregnant women) underwent triplex renal sonography prospectively to determine their renal volumes and right renal artery Doppler indices.

RESULTS

The peak systolic velocity, end diastolic velocity, pulsatility index, systolic/diastolic ratio and acceleration time were respectively significantly higher in the PIH group (68.67 cm/s, 21.55 cm/s, 1.23, 3.38, 123.2 ms) than the pregnant, normotensive group (65.19 cm/s, 20.27 cm/s, 0.88, 3.35, 61.14 ms) and healthy, non-pregnant group (52.06 cm/s, 18.27 cm/s, 0.84, 2.90, 68.48 ms). Resistivity index was also increased in the PIH group, but this was not statistically significant. Conversely, the systolic acceleration was significantly lower in the PIH group (6.06 m/s(2)) compared to the pregnant, normotensive group (11.82 m/s(2)) and healthy, non-pregnant group (8.26 m/s(2)). The right renal volume of the PIH group (132.76 cm(3)) was significantly higher that of the pregnant, normotensive group (125.29 cm(3)) and healthy, non-pregnant group (91.66 cm(3)). The same pattern was observed in the left renal volume which was 168.78 cm(3), 164.95 cm(3) and 113.80 cm(3) in the study groups, respectively.

CONCLUSION

Renal Doppler ultrasound is clinically relevant in the diagnosis and follow-up of renal complications in patients with pregnancy-induced hypertension.