Ultrasonographic Renal Biometry in Diabetic Chronic Kidney Disease at Saint Joseph Hospital in Kinshasa, Democratic Republic of the Congo

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Introduction Chronic kidney disease (CKD) is a major global public health challenge, particularly among patients with diabetes mellitus. In sub-Saharan Africa, ultrasonographic data on renal biometry in diabetic CKD remain limited, and local data from the Democratic Republic of the Congo (DRC) are scarce. Purpose To evaluate renal dimensions using transabdominal ultrasonography in patients followed for diabetic CKD at Saint Joseph Hospital in Kinshasa, to compare these measurements with those of patients with non-diabetic CKD, and to analyze morphological variations according to clinicobiological and ultrasonographic stages. Methods A single-center cross-sectional study was conducted from October 1, 2020, to September 30, 2021. A total of 160 adult patients with nephrologist-confirmed CKD were consecutively enrolled, including 79 diabetic and 81 non-diabetic patients. Clinical, biological, and ultrasonographic data were collected using a standardized case report form. Ultrasonographic measurements included renal long axis (bipolar length), short axis, width, cortical thickness, parenchymal echogenicity, corticomedullary (parenchymo-sinusal) differentiation, and interlobar renal resistive indices (RIs). Statistical comparisons were performed using the Chi-square test, Fisher's exact test, Student's independent t-test, analysis of variance (ANOVA), and paired t-tests, with statistical significance set at p < .05. Results The mean age of the cohort was 57.3 ± 11.7 years. The mean right renal long axis was significantly larger in diabetic patients than in non-diabetic patients (101.4 ± 10.1 mm vs. 86.7 ± 10.6 mm; p < .001), as was the mean left renal long axis (107.1 ± 36.7 mm vs. 88.4 ± 11.4 mm; p < .001). In both cohorts, the left kidney was significantly longer than the right kidney. Renal dimensions decreased progressively with advancing CKD stages, although this reduction was substantially more pronounced in the non-diabetic group. Inter-method agreement between the Kidney Disease: Improving Global Outcomes (KDIGO) functional stages and ultrasonographic structural stages was weak (kappa = 0.15; 95% CI [0.08, 0.24]). Conclusion Renal ultrasonography demonstrates relative preservation of renal dimensions in diabetic patients with CKD compared to non-diabetic patients, who exhibit more marked parenchymal atrophy. In resource-limited settings, ultrasound is an invaluable tool for structural characterization, but it must complement—and not replace—laboratory-based glomerular filtration estimates for clinical staging.