Renal haemodynamics changes in different course of type 2 diabetes mellitus on the Contrast Enhanced Ultrasound evidences

Abstract

Introduction. The currently used ionizing or invasive instrumental methods are considered to be unsuitable for haemodymanics monitoring. Contrast Enhanced ultrasound (CEUS) can provide better images of renal blood flow. Objective. To assess the renal haemodynamics changes in patients with different course of type 2 diabetes on the CEUS evidences. Materials and methods. From 2019 to 2022 118 patients 62 women (52.5 %), 56 men (47.5 %), average age 64±5.2) were examined. The control group was (n=48). The same study design used for all patients included case history, physical examination, SR-36 and DEBQ questionnaires, laboratory examination, multiparametric examination, CEUS. Results. When assessing BMI the 41.02 %, 52.27 % and 42.85 % of patients were found to be overweighted in the 1, 2 and 3 groups, respectively. By the ROC analysis the quantitative parameters of the CUI were obtained: on day 1 AUC=0.6544, after 6 months AUC=0.6492, after 12 months AUC=0.7418, after 24 months AUC=0.7515, after 36 months AUC=0.7529. For ΔPI according to the data, the optimal threshold for cutting off the transition of diabetic kidney disease to CKD is 76.3 dB. Conclusions. 1. The use of ultrasound contrast agents in the diagnosis of CKD enhances the importance of the ultrasound method. 2. qualitative and quantitative parameters of the CUSI allow to assess the renal haemodynamics changes in patients with different course of type 2 diabetes. 3. ΔPI corresponds to a high quality of prognostic model for the CKD dynamics (AUC=0.7418) with an optimal threshold for cutting off the transition of diabetic disease kidneys in CKD 76.3 dB.