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. 2025 Apr 13;17(4):e82202.
doi: 10.7759/cureus.82202. eCollection 2025 Apr.

Role of Renal Resistive Index as an Early Marker of Diabetic Nephropathy in Children With Type 1 Diabetes Mellitus

Preeti Choudhary  1 , Meenakashi Rani  1 , G S Sengar  1
Affiliations

Role of Renal Resistive Index as an Early Marker of Diabetic Nephropathy in Children With Type 1 Diabetes Mellitus

Preeti Choudhary et al. Cureus. .

Abstract

Objective Diabetic nephropathy (DN) is the most common microvascular complication in type 1 diabetes mellitus (T1DM). The study aimed to assess the role of renal resistive index (RRI) in early detection of DN in children with T1DM. Methods This study was conducted on 122 children with T1DM. The following parameters were studied: age, gender of patients, duration of diabetes, number of diabetic ketoacidosis (DKA) episodes, serum creatinine, serum urea, urine albumin excretion (UAE), glycated hemoglobin (HBA1c) and mean RRI of both kidneys. Results The study included 60 (49%) males and 62 (51%) females; with male to female ratio 0.96:1; their mean ages were 9.5 ± 2.89 years (range, 5-14) years and mean disease duration was 3.7 ± 1.6 years (range, 2-10) years; mean value of HBA1c was 11.69 ± 2.1 and 88.5% (108) of cases with T1DM in our study were normoalbuminuric and only 11.4% (14) of cases had albuminuria. The RRI >=0.7 (indicative of DN) was found in 12.2% (15) cases of T1DM in our study. Risk factors significantly associated with DN were age of children (older ages more affected), longer duration of disease, and higher total cholesterol and triglycerides levels. The cases of T1DM with UAE >30 mg/24 hours as well as RRI >=0.7 had significantly higher mean blood urea and serum creatinine levels indicating renal involvement. Conclusion RRI values significantly correlates with renal UAE. RRI abnormality occurs even before the level of UAE reaches the cut-off value of early diagnosis of DN. Hence, RRI (>=0.7) can be used as an early indicator of DN.

Keywords: diabetic nephropathy; pediatric diabetic ketoacidosis; renal resistive index; type 1 diabetes mellitus; urine albumin excretion.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethics and Research Board of Sardar Patel Medical College, Bikaner issued approval No: F.29.(Acad)SPMC/2021/639. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Correlation between Urine Albumin Excretion level and Duration of Diabetes (in years)
Figure 2
Figure 2. Graph showing correlation between serum glycated haemoglobin (HbA1c) and Urine Albumin excretion
Figure 3
Figure 3. Correlation between Mean Renal resistive index and Age of Patients
Figure 4
Figure 4. Relation between urine albumin excretion and renal resistive index
Figure 5
Figure 5. Relation between blood urea level and renal resistive index
Figure 6
Figure 6. Relation between serum creatinine level and renal resistive index
See this image and copyright information in PMC

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