Key result
Supersonic shear imaging elastography predicted eGFR < 30 mL/min/1.73 m² with an AUC of 0.706 (P=0.05), demonstrating 71% sensitivity and 79% specificity at a cutoff of 6.9 kPa.
Why the study?
Renal biopsy is the gold standard for assessing kidney pathology but is invasive, prompting evaluation of supersonic shear imaging elastography as a non-invasive tool to predict histopathological abnormalities.
Does SSI elastography predict renal histopathological abnormalities in adult patients undergoing native kidney biopsy?
Cross-Sectional (n=51)
No
Does SSI elastography predict renal histopathological abnormalities in adult patients undergoing native kidney biopsy?
Effect estimate: AUC 0.706
p-value: p=0.05
Supersonic shear wave elastography shows promise as a non-invasive tool for predicting renal histopathological changes and assessing kidney function in CKD patients.
SSI elastography shows modest accuracy for low eGFR; leaves open validation against histopathology and clinical outcomes in CKD.
BACKGROUND: Chronic kidney disease (CKD) is a global health burden with irreversible progression and cardiovascular risk. Renal biopsy, while the gold standard for assessing kidney pathology, is invasive. Supersonic shear imaging (SSI) elastography is a promising non-invasive tool for quantifying tissue stiffness, potentially reflecting underlying fibrosis. This study aimed to assess the diagnostic value of SSI elastography for predicting renal histopathological abnormalities based on tissue stiffness and to evaluate its correlation with biopsy findings. METHODS: This cross-sectional study included 51 adult patients undergoing native kidney biopsy at Mansoura University Hospitals. All patients underwent SSI elastography before biopsy. Renal stiffness was measured in kilopascals in both kidneys. Histopathological findings, including interstitial fibrosis, tubular atrophy, and glomerulosclerosis, were correlated with elastographic data. RESULTS: Median right and left kidney stiffness were 7 (5.6–8.5) and 7.7 (6.8–10) kPa, respectively. Right kidney stiffness showed significant correlations with age (r = -0.28, p = 0.04) and eGFR (r = 0.288, p = 0.04). In non-lupus nephritis cases, right kidney stiffness correlated negatively with serum creatinine (r = -0.409, p = 0.02) and interstitial fibrosis (r = -0.377, p = 0.03), and positively with eGFR (r = 0.438, p = 0.01). ROC analysis yielded an AUC of 0.706 (p = 0.05) for predicting eGFR < 30 mL/min/1.73 m², with a cutoff of 6.9 kPa (sensitivity 71%, specificity 79%). CONCLUSIONS: Supersonic shear wave elastography (SWE) is a promising non-invasive modality for predicting renal histopathological changes and assessing kidney function in CKD patients.
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Fadl et al. (2026) conducted a cross-sectional in Chronic kidney disease (n=51). Supersonic shear imaging (SSI) elastography vs. Renal biopsy was evaluated on Prediction of eGFR < 30 mL/min/1.73 m² (AUC 0.706, p=0.05). Supersonic shear imaging elastography predicted eGFR < 30 mL/min/1.73 m² with an AUC of 0.706 (P=0.05), demonstrating 71% sensitivity and 79% specificity at a cutoff of 6.9 kPa.
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