Association of Clinical and Biochemical Parameters with Renal Resistive Index in Type 2 Diabetic patients with Normal Albuminuria

Authors

  • Arsalan Shahid Allama Iqbal Teaching Hospital, Dera Ghazi Khan Author
  • Madiha Naseer Shaikh Zayed PGMI, Lahore Author
  • Sudhanshu Kumar Thakur Shaikh Zayed Hospital, Lahore Author
  • Mahwish Farzana Akhtar Saeed Medical & Dental College, Lahore Author
  • Saulat Sarfraz Shaikh Zayed PGMI, Lahore Author

Keywords:

Diabetes mellitus, Diabetic nephropathy, Ultrasonography, Renal artery

Abstract

Objective: To determine the association between the renal resistive index (RRI) and different biochemical and clinical parameters in type 2 diabetic patients with normal albuminuria.

Methodology: This descriptive cross-sectional study was conducted at the Department of Radiology, Shaikh Zayed Hospital, Lahore with a diabetic clinic collaboration for one year from January to December 2023. After ethical approval, 300 type 2 diabetic patients with normal albuminuria <30 mg/g were included by non-probability convenience sampling. After obtaining informed consent, patient demographic and clinical details were noted on the proforma. All the patients underwent renal Doppler ultrasound and RRI was estimated. Various biochemical parameters of the patients were estimated. The data analysis was done using the Statistical Package for the Social Sciences version 25.

Results: The average RRI was >=0.70 in 64(21.3%) patients who were labeled as having nephropathy, >=0.65 to <0.7 in 82(27.4%), and 154(51.3%) had normal RRI. There was a significant association of renal resistive index with duration of diabetes mellitus (DM), serum creatinine, urinary albumin-to-creatinine ratio (ACR), glomerular filtration rate (GFR), fasting blood glucose, glycated hemoglobin (HbA1c), and lipid profile in type 2 diabetic patients with normal albuminuria (p-value=<0.05).

Conclusion: Renal resistive index had a significant association with duration of diabetes, serum creatinine, urinary ACR, GFR, fasting blood glucose, HbA1c, and lipid profile. It can be used for early detection of diabetic nephropathy in type 2 diabetic patients with normal albuminuria.

Author Biography

  • Arsalan Shahid, Allama Iqbal Teaching Hospital, Dera Ghazi Khan

    Senior Registrar Department of Radiology 

References

1. Forouhi NG, Wareham NJ. Epidemiology of diabetes. Medicine. 2022; 50(10):638-43. doi:10.1016/j.mpmed.2022.07.005.

2. Azeem S, Khan U, Liaquat A. The increasing rate of diabetes in Pakistan: a silent killer. Ann Med Surg (Lond). 2022; 79:103901. doi:10.1016/j.amsu.2022. 103901.

3. Antar SA, Ashour NA, Sharaky M, Khattab M, Ashour NA, Zaid RT, et al. Diabetes mellitus: classification, mediators, and complications; a gate to identify potential targets for the development of new effective treatments. Biomed Pharmacother. 2023; 168:115734. doi:10.1016/j.biopha.2023.115734.

4. Farmaki P, Damaskos C, Garmpis N, Garmpi A, Savvanis S, Diamantis E. Complications of the type 2 diabetes mellitus. Curr Cardiol Rev. 2020; 16(4):249-51. doi:10.2174/1573403X1604201229115531.

5. Samsu N. Diabetic nephropathy: challenges in pathogenesis, diagnosis, and treatment. Biomed Res Int. 2021; 2021:1497449. doi:10.1155/2021/1497449.

6. Theertha KC, Das SK, Shetty MS. Renal resistive index: revisited. Cureus. 2023; 15(3):e36091. doi:10.7759/cureus.36091.

7. Darabont R, Mihalcea D, Vinereanu D. Current insights into the significance of the renal resistive index in kidney and cardiovascular disease. Diagnostics (Basel). 2023; 13(10):1687. doi:10.3390/diagnostics13101687.

8. Khairallah MK, Sobh MA, Mansour E, Ibrahim R, Mostafa MH. Renal resistive index as a promising tool in early identification of diabetic nephropathy. Egypt J Hosp Med. 2023; 90(1):1983-7. doi:10.21608/EJHM. 2023.284774.

9. Trutin I, Stipancic G, Sapina M, Oletic L, Laganovic M. Increased renal resistive index as a marker of early stage of diabetic nephropathy in normoalbuminuric children with type 1 diabetes mellitus. Acta Clin Croat. 2024; 63(1):36-44. doi:10.20471/acc.2024.63.01.5.

10. Jenewari EB, Donald RE, Pedro ECC, Chukwuemeka A. Relationship between intra-renal resistive index and markers of renal function status in type 2 diabetic patients in Southern Nigeria. Asian J Res Nephrol. 2023; 6(1):21-32. Available from: https://journalajrn.com/ index.php/AJRN/article/view/56.

11. American diabetes association professional practice committee. Classification and diagnosis of diabetes: standards of medical care in diabetes - 2022. Diabetes Care. 2022; 45(1):S17-38. doi:10.2337/ dc22-S002.

12. Chawla R, Navpute K, Garg N, Dhingra J, Jaggi S. Resistive index (RI) on renal Doppler as an early marker for detecting diabetic nephropathy (DN). Endocrine Practice. 2023; 29(5):S19-20. doi:10.1016/j.eprac. 2023.03.048.

13. Kasozi RN, Meeusen JW, Lieske JC. Estimating glomerular filtration rate with new equations: can one size ever fit all? Crit Rev Clin Lab Sci. 2023; 60(7):549-59. doi:10.1080/10408363.2023.2214812.

14. Kumar S, Kumari B, Kaushik A, Banerjee A, Mahto M, Bansal A. Relation between HbA1c and lipid profile among prediabetics, diabetics, and non-diabetics: a hospital-based cross-sectional analysis. Cureus. 2022; 14(12):e32909. doi:10.7759/cureus.32909.

15. Jung HH. Evaluation of serum glucose and kidney disease progression among patients with diabetes. JAMA Netw Open. 2021; 4(9):e2127387. doi:10.1001/jamanetworkopen.2021.27387.

16. Tahir S, Shafique M, Ali D, Khan MB, Sadiq T, Rehman H. Determination of renal resistivity index in patients having type II diabetes mellitus. Pak Armed Forces Med J. 2020; 70(3):649-53. Available from: https://www.pafmj.org/PAFMJ/article/view/4596.

17. Kuttancheri T, Das SK, Shetty MS, Satish S, Bathrenathh B. Renal resistive index as a marker of histopathological damage in diabetic and non-diabetic chronic kidney disease. Egypt J Radiol Nucl Med. 2023; 54:159. doi:10.1186/s43055-023-01096-9.

18. Kharsa C, Beaini C, Chelala D, Aoun M. Association of renal resistive indices with kidney disease progression and mortality. BMC Nephrol. 2023; 24(1):348. doi:10.1186/s12882-023-03398-6.

19. Nasir M, Maryam S, Qadir SA, Fatima M. Correlation between renal artery resistive index and renal function tests in type II diabetic patients. AJHS. 2024; 1(3):62-6. Available from: https://avicennajhs.com/ajhs/article/view/32.

20. Joseph AM, Kharadi B. A comprehensive study to find the association between biochemical markers and renal resistive index in patients with diabetes mellitus. IJRDI. 2021; 4(3):34-40. doi:10.33545/26644436.2021.v4.i3a.217.

21. Khan A, Ahmed A, Bhutta MR, Zafar I, Khan MNN, Ehsan J. Correlation between resistive index and serum creatinine in patients with diabetic nephropathy. Pak Armed Forces Med J. 2023; 73(2):435-8. doi:10.51253/pafmj.v73i2.7625.

22. Fatima N, Hameed H, Khan Y, Tahir S, Rehman H. Correlation of renal resistive index with serum creatinine and albuminuria in patients of diabetic nephropathy. IJHR. 2025. 3(3):723-9. doi:10.71000/y0j6mf59.

23. Romano G, Mioni R, Danieli N, Bertoni M, Croatto E, Merla L, et al. Elevated intrarenal resistive index predicted faster renal function decline and long-term mortality in non-proteinuric chronic kidney disease. J Clin Med. 2022; 11(11):2995. doi:10.3390/ jcm11112995.

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Published

2025-06-10

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Original Article

How to Cite

Association of Clinical and Biochemical Parameters with Renal Resistive Index in Type 2 Diabetic patients with Normal Albuminuria. (2025). Journal of Sharif Medical & Dental College, 11(01), 49-54. https://ojs.jsmdc.pk/index.php/jsmdc/article/view/29

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