Key result
Higher blood pressure and arterial stiffness were significantly correlated with decreased kidney shear wave speed (e.g., r=-0.65, p=0.02 for diastolic BP) in diabetic kidney disease.
Why the study?
Is kidney stiffness measured by elastography influenced by vascular factors such as blood pressure and arterial stiffness in patients with diabetic kidney disease?
Cross-Sectional (n=38)
Is kidney stiffness measured by elastography influenced by vascular factors such as blood pressure and arterial stiffness in patients with diabetic kidney disease?
Kidney stiffness measured by elastography in diabetic kidney disease is inversely correlated with blood pressure and arterial stiffness, suggesting it is primarily influenced by renal blood flow rather than chronic kidney disease stage.
Vascular factors may confound kidney elastography readings in diabetic kidney disease; leaves open its validity as an independent marker of parenchymal stiffness.
Studies published so far using ultrasound-based elastography in the kidneys, lack to prove a clear relationship between kidney shear wave speed (KSWS) and renal disease progression. Taking into account that the kidney is a highly vascularized organ, the present study aims to find a relationship between KSWS and vascular factors (blood pressure [BP], arterial stiffness). Our study included 38 diabetic kidney disease patients (mean age 56.52 ± 16.12 years, 19 female, 19 male). KSWS, an indicator of renal stiffness, was measured using point Shear Wave Elastography (pSWE; Siemens Acuson S2000). In every patient, we recorded BP, and we measured aortic augmentation index (AAI) and brachial pulse wave velocity (PWV), using oscillometry. We found statistically significant indirect correlations of KSWS with indicators of arterial stiffness, such as PWV ( r = -.41, p = .036), and AAI ( r = -.37, p = .031). We found also an indirect correlation of KSWS with diastolic BP ( r = -.65, p = .02) and systolic BP ( r = -.54, p = .008). We found no correlation of KSWS with estimated glomerular filtration rate (eGFR), urinary albumin/creatinine ratio, stage of diabetic retinopathy, or glycated hemoglobin. Our study shows that high BP and the progression of arteriosclerosis (high PWV and AAI), leads to a decrease of renal stiffness. Thus, it seems that KSWS is influenced by renal blood flow, rather than other factors, such as albuminuria or chronic kidney disease stage.
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Bob et al. (2018) conducted a cross-sectional in Diabetic kidney disease (n=38). Vascular factors (blood pressure, arterial stiffness) was evaluated on Correlation of kidney shear wave speed (KSWS) with vascular factors (r = -0.65 for diastolic BP; r = -0.54 for systolic BP; r = -0.41 for PWV; r = -0.37 for AAI, p=p = .02 for diastolic BP; p = .008 for systolic BP; p = .036 for PWV; p = .031 for AAI). Higher blood pressure and arterial stiffness were significantly correlated with decreased kidney shear wave speed (e.g., r=-0.65, p=0.02 for diastolic BP) in diabetic kidney disease.
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