Evaluation of Renal Blood Flow with Renal Duplex Doppler Sonography in Diabetic Patients with Nephropathy

Abstract

The relationship between the resistive index (RI), pulsatility index (PI) or the acceleration index (AI) of renal interlobular arteries and the progression of diabetic nephropathy were studied using duplex Doppler sonography in 159 diabetic patients, 22 age-matched non-diabetic patients with hypertension, and 18 age-matched non-diabetic subjects without hypertension. The three parameters of renal blood flow obtained from this method were higher in diabetic patients than in nondiabetic subjects without hypertension. The RI and the Al, however, were higher in non-diabetic patients with hypertension than in those without hypertension. In diabetic patients, the 3 parameters increased in parallel with the increases in albumin excretion. The AI was the most strongly positively correlated with serum creatinine and urinary albumin excretion in all diabetic patients. The three parameters were inversely correlated with glomerular filtration rate (GFR) and renal plasma flow (RPF).
These results indicate that all three parameters (RI, PI and AI) of these arteries markedly increased in diabetic patients, especially in those with overt nephropathy, and suggest that the AI and RI or PI values may be useful in the evaluation of the progression of nephropathy in diabetic patients.