Abstract

RENAL DOPPLER DUPLEX ULTRASOUND AS A PREDICTOR OF RENAL IMPAIRMENT IN PATIENTS WITH HCV INFECTION AND ITS CORRELATION WITH RENAL FUNCTION TEST (SERUM CREATININE AND URINARY PROTEIN)

*Dr. Talal Habib, MBBS, FCPS, Dr. Usama Habib and Dr. Heba Tul Noor

Abstract

Background: Renal arterial waveform analysis done by renal Duplex Doppler Ultrasound provides a safe, reliable and real time estimation of renal hemodynamics without any downtime and doubts as it avoids various factors that make estimation of renal function challenging. Objective: To assess the clinical validity of RI and to determine the correlation between RI and RFT’s for evaluation of renal function in patient. Aanalytical cross sectional study was conducted at Department of Radiology, DHQ Teaching Hospital Gujranwala and it included 158 hepatitis C positive patients and 79 healthy individuals after approval of synopsis. After validation of inclusion and exclusion criteria, patients were divided in into 4 groups (A to D) according to stage of disease and controls were kept in Group E. Grey scale ultrasound assessment for renal measurements and renal echogenicity was done. Sagittal and axial scans was taken in supine position from anterior approach using liver and spleen as an acoustic window. The size and texture of liver was also assessed. Color Doppler was performed to get Resistive Index (RI) using standard curvilinear probe. Results: Serum Creatinine and Urea levels were considerably higher among diseased groups as compared to the control group. The highest creatinine level was observed in Group- D 1.05±0.20, followed by group C, B and A. Same trend was observed for Urea level i.e. highest in Group-D 49.67±14.19. Similarly, mean RI was significantly higher in diseased groups (highest: Group-D; 0.78 & 0.81 in right and left kidneys respectively. Conclusion: RI and RFT’s have positive correlation among them. RI taken on Doppler duplex ultrasound is a reliable, non-invasive, simple, instant and cost effective method for evaluation of renal hemodynamics in cirrhotic patients with HCV. As compared to RFT’s, it can predict disease progression at an early stage, even before establishment of clinical symptoms and derangement of RFT’s.

Keywords: Renal Resistive Index (RI), Renal Doppler Duplex Ultrasound, Renal function tests, Urea, Creatinine, Cirrhosis, HCV.