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Med. J. Cairo Univ
Med. J. Cairo Univ
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| Abstract: |
Aim of Work: To evaluate the role of point shear wave
elastography (pSWE) in detecting degree of renal fibrosis and
correlating it to deterioration of renal function in chronic
kidney disease patients.
Background: Chronic kidney disease (CKD) is diagnosed
by either of the following lasting for more than 3 months:
Decrease of glomerular filtration rate (GFR) less than
60ml/min/1.73m2 which is the best index of kidney function,
or presence of markers for kidney damage as albuminuria.
Renal fibrosis is nearly the ultimate common pathway for all
CKD. The main method in clinical use for the assessment of
renal fibrosis is the renal biopsy which is known for its
considerable disadvantages like its invasive nature, with a
risk of further complications, high cost, inter-observer variability, and sampling error. Shear wave elastography (SWE)
is one of the promising techniques that allow non-invasive
estimation of tissue stiffness.
Material and Methods: This study was performed at the
Radiodiagnosis Department, Zagazig University. We examined
42CKD patients who underwent pSWEas well as laboratory
detection of Estimated glomerular filtration rate (eGFR).
Patients were classified according to GFR into fivestages:
Into stage 1 (eGFR ≥90), stage 2 (eGFR 60-89), stage 3 (eGFR
30-59), stage 4 (eGFR 15-29), and stage 5 (eGFR <15). All
analyses were done using the Statistical Package for theSocial
Sciences 20.0 software.
Results: The mean value of SWE (kPa) in CBD patients
(5.44±1.4). The mean SWE values in the CKD stages were
3.65±0.9, 4.5±1.2, 5.8±0.5, 5.3±1.1, 6.6±0.9 kPa in stages
1,2,3,4, and 5 respectively. There was no significant difference
between CKD stages except between stage 1 vs. 5 and stage
2 vs. 5.Only age showed a significant correlation with SWE
in CKD patients (r=0.453; p=0.039). The laboratory investigationrevealed that 6 patients stage I (110±26.5), 8 patients
stage II (71.5±1), 8 patients stage III (45.5±8.3), 6 patients
stage IV (23±6.2) and 14 patients stage V (8.3±2.8). The cutoff value for predicting CKD was 4.05 kPa with 85.70%
sensitivity and 90.5% specificity, while for predicting kidney
fibrosis it was 4.45 kPa with 93.3% sensitivity and 83.3%
specificity
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