Resistive Index as a Marker of Renal Pathology in Children with Chronic Kidney Disease; Is It Useful?

 Chronic kidney disease is a global health concern, its detection and diagnosis in earlier stages is also a great challenge that can alleviate this burden. Kidney biopsy is important to establish histopathological patterns. But, it is invasive. We aimedto evaluate the correlation of renal resistive index (RI) measured by Doppler ultrasound with the progression of chronic kidney disease and to evaluate its significance as non-invasive marker of renal histological damage. Materials and Methods This is a prospective cross sectional study conducted at El Minia Pediatric University Hospital, El Minia, Egypt, and included a total of 57 children: 38 patients with different stages of chronic kidney disease (group I), and 19 healthy children served as controls (group II). Full history, examinations and some laboratory investigations as 24th protein in urine, serum urea and creatinine concentrations were done. All participants underwent renal Doppler ultrasonography and a kidney biopsy was taken from CKD patients.

Resistive index was significantly higher in patients group (group I) compared to control group. In CKD patients there was a significant positive correlation between RI and stages of CKD (r=0.47, p<0.05). Also, there was a significant positive correlation between RI and histological indices. However, significant negative association was found between RI and both eGFR (r=-0.49, p<0.05), and renal length (r=-0.40, p<0.05). Conclusion Resistive index increases with the progression of CKD and it is correlated with the histological indices. So, RI as a non-invasive technique could be considered as a marker of renal function and histological damage in CKD patients and it could be a non-invasive indicator for monitoring the progression of renal disease.