Observation And Analysis Of Renal Hemodynamics With Color Doppler Ultrasonography In Early Diabetic Kidney Disease

Objective: Diabetic kidney disease(DKD),as one of the most common and serious complications of diabetes mellitus(DM),has become the main cause of chronic kidney disease(CKD)and end-stage renal disease(ESRD).Early detection,diagnosis and treatment can delay and reverse renal damage,which is the key to reduce the mortality of DM patients.In this study,the value of color Doppler ultrasonography in the diagnosis of early diabetic kidney disease was discussed by observing and analyzing the changes of renal hemodynamics in patients with early diabetic kidney disease.Methods:A total of 40 patients with early diabetic kidney disease admitted to the Department of Endocrinology and Nephrology of the First Hospital of Hebei Medical University from September 2019 to September2020 were selected as the observation group,including 26 males and 14 females,aged 36 to 76 years old,with an average age of(58.33 ±12.69)years old.All the selected subjects were in accordance with the international WHO diagnostic criteria for type 2 diabetes(1997).The Urinary albumin creatintine ratio(UACR)was used as an indicator for the diagnosis of early diabetic kidney disease,namely 30mg/g≤UACR≤300mg/g.At the same time,40 healthy subjects in our hospital during the same period were randomly collected as the control group,including 19 males and 21 females,aged 19 to64 years old,with an average age of(40.38±12.87)years old.The TOSHIBA Aplio 500 color Doppler ultrasonography instrument was used for the detection of renal artery in the two groups.The peak systolic velocity(PSV)and end diastolic velocity(end-diastolic velocity)of the Master renal artery(MRA),segmental renal artery(SRA)and interlobar renal artery(IRA)in the left and right kidneys were measured(EDV)and Interlobar renal artery(RI),All ultrasonic measurement indexes were taken as the mean value of both kidneys,and the peak systolic velocity,end-diastolic velocity and resistance index of main renal artery,segment artery and interlobar artery were compared between the two groups.Receiver operating characteristic curve(ROC)was constructed to obtain the area under the curve,and the diagnostic value of color Doppler ultrasonography in early diabetic kidney disease was analyzed.Results: The peak systolic blood flow velocity and end diastolic blood flow velocity of the main renal artery,renal segment artery and interlobar artery in the observation group were lower than those in the control group,with statistical significance(P<0.05).The resistance index of the main renal artery,renal segmental artery and renal interlobar artery were all higher than those in the control group,with statistical significance(P<0.05).According to the peak systolic flow velocity,end-diastolic flow velocity and resistance index of the main renal artery in patients with early diabetic kidney disease,the area under the ROC curve(AUC)was 0.713,0.786 and 0.830,respectively.According to the peak systolic flow velocity,end-diastolic flow velocity and resistance index of renal segment arteries,the area under the ROC curve(AUC)of early diabetic kidney disease was predicted to be 0.728,0.768 and 0.847,respectively.According to the peak systolic flow velocity,end-diastolic flow velocity and resistance index,the area under the ROC curve(AUC)of early diabetic kidney disease was predicted to be 0.748,0.821 and0.930,respectively.Conclusion:1、In patients with early diabetic kidney disease,renal blood flow velocity slowed down and vascular resistance increased,showing the characteristics of high resistance,low flow velocity and low perfusion.2、The resistance index of the main renal artery,renal segment artery and interlobar artery is of high value in predicting the clinical application of early diabetic kidney disease,while the peak systolic flow velocity and end-diastolic flow velocity are of low value in predicting the clinical application of early diabetic kidney disease.3 、 Using color Doppler ultrasonography to detect renal artery hemodynamics in early diabetic patients can provide diagnostic basis for the early diagnosis of diabetic kidney disease and has high clinical application value.