Sonographic grading of renal cortical echogenicity and raised serum creatinine in patients with chronic kidney disease

Abstract

Introduction: Chronic Kidney Disease (CKD) is a worldwide public health problem, both for the number of patients and cost of treatment involved. Globally, CKD is the 12th cause of death and the 17thcause of disability, respectively. This is an underestimate as patients with CKD are more likely to die of cardiovascular disease than to reach End-Stage Renal Disease (ESRD).Materials and Methods: Two Hundred patients, clinically diagnosed with chronic kidney disease (GFR <60/mL/min calculated by using Cockcroft-Gault equation, for three months or more) above the age of 18 years, referred to the Department of Medicine, Radiodiagnosis, Prathima Institute of Medical Sciences, Karimnagar from January 2020 to December 2020. Results: The grade of renal disease was determined by cortical echogenicity with Grade 1 mild form, Grade 2 moderate and Grade 3 severe form and Grade 4 as end-stage renal disease. The mean serum creatinine was 2.87 mg/dL for Grade 1, 3.27 mg/dL for Grade 2, 4.3 mg/dL for Grade 3 and 5.8 mg/dL for Grade 4. No correlation was observed between renal length, parenchymal thickness and cortical thickness with serum creatinine levels. The grading of renal echogenicity on sonography correlated well with serum creatinine in CKD than any other sonographic parameters with a statistically significant positive correlation (P<0.001).Conclusion: The renal cortical echogenicity has its advantages of being irreversible compared to serum creatinine levels, which improve with renal replacement therapies like haemodialysis and peritoneal dialysis. Also, quantification of echogenicity of the renal cortex relative to that of the liver has been shown to be reproducible with only little variability between different scanners and probes in previous studies.