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

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
  • Alappan, Raj, Renal Associates, LLC, Columbus, Georgia, United States
  • Sehgal, Raj, Radiology Institute , Atlanta, Georgia, United States
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.