Kidney Week

Abstract: FR-PO418

A New Way to Assess CKD Progression: Correlation of Renal Ultrasound Measurements to Co-Morbidities, CKD Stages, and Total Renal and Parenchymal Cortical Volume

Session Information

• CKD: Risk Factors for Incidence and Progression - I
  November 03, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Chronic Kidney Disease (Non-Dialysis)

• 301 CKD: Risk Factors for Incidence and Progression

Authors

• Alappan, Harish Raj, Emory University - Undergraduate, Atlanta, Georgia, United States

Harish Raj Alappan,

• Alappan, Raj, Renal Associates, LLC, Columbus, Georgia, United States

Raj Alappan,

• Sehgal, Raj, Radiology Institute , Atlanta, Georgia, United States

Raj Sehgal,

Background

Correlating Renal Ultrasound (US) data to co-morbidity and Chronic Kidney Disease (CKD) stages is sparse. Kidney’s volumetric US data and trends have not been reported previously in CKD stages.

Methods

Initial CKD evaluation was conducted at Renal Associates. Clinical data and renal US done at the center were analyzed. Using the M7-Mindray US System, the same radiographer did the imaging and the same radiologist read images. 612 renal US images from Aug. 2014 to Jan. 2016 were analyzed. The Renal and Medullary sagittal, transverse and AP axis and cortical thickness for the right (RK) and left (LK) kidneys were measured in cm. Using Total Renal (TRV), and the Medullary (MV) volume, the Cortical (CV) volume was calculated. Using a correction constant for each kidney (RK=0.4891, LK=0.4886) the true renal Cortical tissue Volume (RCV) was determined for each kidney.

Results

Overall study (n=612): mean age was 63.87 yrs., 339 (55.3%) females, BMI 31.23, Cr 1.49 mg/dL, CrCl 73.02 mL/min, PTH 62.14 and HCO₃ at 25.52. The RK and LK sagittal size was 10.72 cm and 10.71 cm (p-NS), cortical thickness was 1.51 cm and 1.59 cm (p<0.004), renal stone 54(8.8%), and 204 had renal cysts (34.6%).
CKD stages correlated to both RK and LK for corrected TRV of 171.23 cm³ and 178.32 cm³, Cortical tissue volume 151.09 cm³ and 154.44 cm³ (p<0.001), and Combined total cortical tissue volume in male 356.89 cm³ and female 263.99 cm³ (p<0.001). For 1mL of the RCV(cm³), Cr Cl per mL ratio linearly increased as CKD Stages advanced (3.125 cm³ in Stage-1 to 9.62 cm³ in Stage-4). All males and diabetics had a larger sagittal, cortex and renal Cortical volume. Af. Am had thicker cortex (see Table).

Conclusion

This study is the first of its kind that correlates renal measurements on Total Renal Volume and Renal Cortical Volume to CKD Stages and other co-morbidities. Cortical thickness and volumetric corrected Renal Cortical Volume in cm³ were accurate and significant. We propose with this study a new way to use ultrasound to monitor CKD progression.