Evaluation Of The Abnormality Of Intra-renal Arterial Resistance Index And Its Correlation With Carotid Artery Atherosclerosis In Type2Diabetes Nephropathy With Ultrasonography

Objective: To evaluate the abnormality of intra-renal arterial resistance index (RI) ofthe patients of type2diabetic nephropathy and its correlation with carotid arteryatherosclerosis.Methods:62subjects with type2diabetic nephropathy were enrolled and categorizedinto3groups according to GFR level: GFR≥90ml/(min·1.73m2) as group A(24cases)，60ml/(min·1.73m2)≤GFR<90ml/(min·1.73m2)as group B(25cases),GFR<60ml/(min·1.73m2) as group C(13cases).And,25healthy volunteers were recruited as thecontrol group (group D). The intra-renal arterial RI and carotid IMT were obtained bycolor Doppler ultrasonography. The vascular remodeling rate and remodelingtypes(without remodeling, positive remodeling and negative remodeling) of carotidartery were obtained.Results: The differences of RI（F=3.873,P＜0.05）and IMT（F=4.329,P＜0.05）among four groups were significant, Both IMT and RI of group A, B, C weresignificantly higher than those of group D(all P＜0.05). Both IMT and RI of group Cwere higher than that of group B and group B are higher than that of group A(all P＜0.05). RI was positive correlative with IMT (r=0.48， P＜0.05), and negativecorrelative with eGFR（r=-0.34, P＜0.05）respectively. The remodeling rate as well asnegative remodeling was progressively increased as the GFR level raised. Theremodeling rate of group D was lower than that of group A,B,C (all P＜0.05), andgroup C are higher than that of group B while group B are higher than that of group A(all P＜0.05). There was a significant difference only between group C and D in negative remodeling. Positive remodeling was dominant in group A, B and C whereasgroup C was mostly vessels without remodeling. A RI=0.73was selected to be the cut-off point as an indicator of server renal damage in DN patient. Subjects with RI above0.73had higher IMT than those with lower value(P＜0.05).Conclusion: The progress of renal function and atherosclerosis of the patients withtype2diabetic nephropathy can be evaluated by intra-renal arterial RI obtained by colorDoppler ultrasonography. And it plays an important role in early detection andprevention of renal injury and progress of atherosclerosis.