Relationship between the estimated glomerular filtration rate and kidney shear wave speed values assessed by acoustic radiation force impulse elastography: a pilot study

Abstract

Objectives: The aim of the study was to establish the relationship between the estimated glomerular filtration rate (GFR) and kidney shear wave speed values assessed by acoustic radiation force impulse (ARFI) elastography.

Methods: Our study included 104 patients with or without chronic kidney disease in which the kidney shear wave speed was evaluated by ARFI elastography and correlated with the estimated GFR. Five ARFI measurements were performed in the parenchyma of each kidney. A median value expressed as meters per second was calculated.

Results: Five valid ARFI elastographic measurements were obtained in the right kidney in all patients and in the left kidney in 97.1% of patients. The mean kidney shear wave speed values ± SD in the right and left kidneys were similar: 2.17 ± 0.81 versus 2.06 ± 0.75 m/s (P = .30). The mean kidney shear wave speed decreased with the decrease in the estimated GFR. Statistically significant differences were obtained only when kidney shear wave speed values obtained in patients with an estimated GFR of greater than 90 mL/min/1.73 m(2) were compared to values in patients with stage 4 (estimated GFR, 15-29 mL/min/1.73 m(2)) and stage 5 (estimated GFR, <15 mL/min/1.73 m(2)) chronic kidney disease: 2.32 ± 0.83 versus 1.62 ± 0.75 m/s (P = .03) and 2.32 ± 0.83 versus 1.66 ± 0.72 m/s (P = .04), respectively. For a cutoff value of 2.26 m/s or lower, kidney shear wave speed had 86.7% sensitivity, 48.3% specificity, a 22.1% positive predictive value, and a 95.6% negative predictive value (area under the receiver operating characteristic curve, 0.692; P = .008) for predicting the presence of an estimated GFR of less than 30 mL/min/1.73 m(2).

Conclusions: Kidney shear wave speed values obtained by ARFI elastography decrease with the decrease in the estimated GFR.

Keywords: acoustic radiation force impulse elastography; chronic kidney disease; genitourinary ultrasound; glomerular filtration rate; kidney shear wave speed.