Changes Of Renal Artery Resistance Index And Its Correlation With Early Renal Injury In Patients With Chronic Kidney Disease

Objectives: To investigate the changes of renal artery resistance index(RRI)in patients with chronic kidney disease(CKD)and its clinical significance for early identification and diagnosis of renal impairment in CKD.Method:611 patients with chronic kidney disease admitted to the First Affiliated Hospital of Hainan Medical University from January 2016 to September 2020 were randomly selected as the case group.According to the glomerular filtration rate(e GFR)calculating by the CKD-EPIScr equation,the case group was divided into 5groups.They were e G1 group[e GFR≥90ml/(min·1.73m2)],e G2 group[e GFR60-89ml/(min·1.73m2)],e G3 group[e GFR 30-59 ml/(min·1.73m2)],e G4 group[e GFR15-29ml/(min·1.73m2)],and e G5 group[e GFR<15ml/(min·1.73m2)].Meanwhile,100 healthy persons were also chosen as the control group.The data of the renal artery resistance index detected by color Doppler ultrasound and serum β2-microglobulin(β2-MG),serum Cystatin C(Cys-C),serum creatinine(Scr)and serum urea nitrogen(BUN)measured by biochemical analyzer were recorded,which was used for analyze the relationship with CKD.Results: 1.With the decrease of renal function,the levels of RRI,β2-MG,Cys-C,Scr and BUN in each case group were increased gradually.The average value of RRI increased abnormally from e G1 group to e G5 group;the mean values of serum β2-MG and Cys-C increased abnormally from e G2 group to e G5 group;the average values of serum Scr and BUN increased abnormally from e G3 group to e G5 group;the differences between the control group were statistically significant(P < 0.05).2.RRI,β2-MG,Cys-C,Scr,BUN were negatively correlated with e GFR,with Cys-C having the strongest correlation with e GFR;β2-MG,Cys-C,Scr,BUN were positively correlated with RRI,and β2-MG and Cys-C were the most closely related to RRI.3.The area under ROC curve(0.992)and The Jorden index(0.915)of the combined detection of RRI,β2-MG and Cys-C were the largest.Conclusions: 1.For patients with CKD,RRI,β2-MG and Cys-C can reflect renal function damage earlier and more accurately than Scr and BUN,especially RRI,which can truly and sensitively reflect the changes of renal function in the early stage of renal damage.2.The combined detection of RRI,β2-MG and Cys-C can detect renal function damage in CKD patients more earlier than single detection,providing clinical reference value for the early diagnosis and treatment of patients with CKD.