Abstract: SA-PO0815
Noninvasive Assessment of Kidney Fibrosis Using Ultrasound Shear-Wave Elastography
Session Information
- Glomerular Management: Real-World Lessons and Emerging Therapies
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Gau, Tyng-shiuan, National Taiwan University Hospital Hsinchu Branch, Hsinchu City, Taiwan
- Chang, Fan-Chi, National Taiwan University Hospital, Taipei City, Taiwan
Background
Kidney fibrosis is a hallmark of chronic kidney disease (CKD), associated with tissue stiffening and functional decline. Ultrasound shear-wave elastography (SWE) offers a noninvasive method to quantify tissue stiffness. This study aimed to validate the utility of SWE in assessing kidney fibrosis and function in patients undergoing native kidney biopsy.
Methods
Patients who underwent SWE and kidney biopsy at National Taiwan University Hospital from December 2021 to October 2024 were included. Clinical, laboratory, and histologic data, including the tubulointerstitial injury score (TIS), were collected. Logistic regression identified predictors of severe tubulointerstitial injury (TIS ≥7). Diagnostic performance was assessed using receiver operating characteristic (ROC) curves.
Results
Among 194 patients (median age 49 years; 65.5% female), 28.9% had severe tubulointerstitial injury. Severe injury was significantly associated with age, diabetes, hypertension, hemoglobin, blood urea nitrogen, serum creatinine, estimated glomerular filtration rate (eGFR), kidney length, and mean elasticity (odds ratio per kPa increase: 1.084; P = 0.002). Shear-wave elasticity remained an independent predictor of severe injury in multivariate analysis. Among patients with eGFR ≥45 mL/min/1.73m2, area under the ROC curve (AUC) of shear-wave elasticity alone was 0.680. Combining shear-wave elasticity with eGFR improved diagnostic performance (AUC: 0.802).
Conclusion
Ultrasound SWE is a practical, noninvasive tool for assessing kidney fibrosis and injury severity. Its integration with eGFR enhances diagnostic accuracy, particularly in patients with preserved kidney function. Further studies are needed to standardized SWE protocols and explore its prognostic value in CKD management.
ROC curves comparing the diagnostic performance of eGFR, shear-wave elasticity, and a combined model integrating both measures in patients with eGFR ≥45 ml/min/1.73m2. The integrated model demonstrated superior discrimination in predicting severe tubulointerstitial injury.
Funding
- Government Support – Non-U.S.