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. 2024 Dec 6:17:307-317.
doi: 10.2147/IJNRD.S480501. eCollection 2024.

Value of Shear Wave Elastography in the Evaluation of Chronic Kidney Disease

Shivarajkumar K Lakshmana  1 , Prakashini Koteshwar  1 , Tanushree Kamath  1
Affiliations

Value of Shear Wave Elastography in the Evaluation of Chronic Kidney Disease

Shivarajkumar K Lakshmana et al. Int J Nephrol Renovasc Dis. .

Abstract

Purpose and motivation: Chronic kidney disease (CKD) is a major global public health problem with eventual progression to end-stage renal disease which tends to increase kidney stiffness. Shear wave elastography (SWE) is a recently developed ultrasound based technique which can be used to assess tissue stiffness noninvasively. The aim of this study was to evaluate the potential diagnostic value of SWE to assess renal parenchymal stiffness in CKD and its correlation with estimated glomerular filtration rate (eGFR), which may be used as a marker for detecting and staging CKD.

Materials and methods: The study protocol was approved by the Institutional ethics Committee at Kasturba medical college, Manipal and written informed consent was obtained from all participants. The study included 93 control subjects and 108 patients with CKD. SWE imaging was performed to assess renal cortical stiffness, as measured by the Young's modulus (YM). Correlations between SWE and conventional ultrasound parameters with age, serum creatinine, eGFR and serum urea were analysed using Pearson's correlation coefficient (p ≤ 0.05) and receiver operating characteristic (ROC) curves were derived.

Results: The diagnostic performance of SWE correlated with serum creatinine levels and eGFR. We found a statistically significant difference in kidney stiffness values between healthy individuals and CKD patients. The Spearman correlation coefficient revealed moderate negative linear correlation between the YM measurements and eGFR. We obtained a YM measurement cut-off value of 4.43 kPa, a value less than or equal to this suggested a no diseased kidney. This yielded sensitivity and specificity of 92.6% and 80.6%, respectively, with an AUROC of 0.92.

Conclusion: Our results demonstrated that shear wave elastography may provide a low-cost, non-invasive method for the morphological assessment and progression of the disease status in chronic kidney disease patients with CKD.

Keywords: chronic kidney disease; renal parenchymal stiffness; shear wave elastography.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
B-mode image and report showing the ROI placement (white box) in the cortex of a patient with CKD stage-5 with average YM measurement of 9.16 kPa.
Figure 2
Figure 2
B-mode image and report showing the ROI placement (white box) in the cortex of a patient with CKD stage-4 with average YM measurement of 7.78 kPa.
Figure 3
Figure 3
B-mode image and report showing the ROI placement (white box) in the cortex of a patient with CKD stage-3 with average YM measurement of 6.26 kPa.
Figure 4
Figure 4
B-mode image and report showing the ROI placement (white box) in the cortex of a patient with CKD stage-2 with average YM measurement of 5.39 kPa.
Figure 5
Figure 5
B-mode image and report showing the ROI placement (white box) in the cortex of a patient with CKD stage-1 with average YM measurement of 4.81 kPa.
Figure 6
Figure 6
ROC curve of YM in distinguishing between CKD and control groups.
Figure 7
Figure 7
Boxplot showing the correlation between CKD stage and YM measurements.
See this image and copyright information in PMC

References

    1. Varughese S, Abraham G. Chronic kidney disease in India: a clarion call for change. Clin J Am Soc Nephrol. 2018;13(5):802–804. doi:10.2215/CJN.09180817 - DOI - PMC - PubMed
    1. Eiro M, Katoh T, Watanabe T. Risk factors for bleeding complications in percutaneous renal biopsy. Clin Exp Nephrol. 2005;9:40–45. doi:10.1007/s10157-004-0326-7 - DOI - PubMed
    1. Sanusi AA, Arogundade FA, Famurewa OC, et al. Relationship of ultrasonographically determined kidney volume with measured GFR, calculated creatinine clearance and other parameters in chronic kidney disease (CKD). Nephrol Dial Transplant. 2009;24(5):1690–1694. doi:10.1093/ndt/gfp055 - DOI - PubMed
    1. Moccia WA, Kaude JV, Wright PG, Gaffney EF. Evaluation of chronic renal failure by digital gray-scale ultrasound. Urol Radiol. 1981;2:1–7. doi:10.1007/BF02926687 - DOI - PubMed
    1. Geddes CC, Baxter GM. Renal impairment. Imaging. 2008;20(1):1–9. doi:10.1259/imaging/63493570 - DOI