Özlem TÜRKSOY, Hüsnü TOKGÖZ, Eda ELVERİCİ, Şule DİLMAN, Enis YÜKSEL

Renal B-mod ultrasonografi bulgularının diabetik nefropati evresi ile ilişkisi

Amaç: Çalışmamızda diabetik nefropati’nin farklı evrelerindeki hastalarda, B-mod Ultrasonografi (US) ile tespit edilen renal morfolojik özelliklerin kontrol grubu kullanılarak karşılaştırılması amaçlanmıştır. Yöntem: Kontrol grubu olarak 20 sağlıklı kişi alınmıştır. Çalışma grubu olarak ise tip-2 diabet tanısı olan 69 hasta alınmıştır. Heriki gruptaki hastalar böbreklerin boyutu; parenkim kalınlığı ve parenkim eko şiddeti yönünden B-mod US ile değerlendirilmiştir. Diabetik hastalar, 24 saatlik idrardaki albumin ekskresyon oranlarına (AEO) göre 3 gruba ayrılmıştır (Grup-1: AEO 300 mg/ gün); ve her grup için ortalama renal parenkim kalınlığı ve renal uzunluk hesaplanmıştır. SPSS programı kullanılarak, bu değerler için gruplar arası karşılaştırma yapılmıştır. Bulgular: Böbrek boyutlarına göre, çalışma grubu ile kontrol grubu arasındaki farklılık araştırıldığında, istatistiksel olarak anlamlı farklılık gözlenirken, ortalama parenkim kalınlığının kontrol grubu ile hasta grupları arasında istatistiksel olarak farklı olmadığı görülmüştür. Hasta grupları, kendi içinde kıyaslandığında yine istatistiksel olarak anlamlı farklılık izlenmemiştir. Kortikal hiperekojenite saptanma oranlarının,ortalama serum BUN ve kreatinin klerens değerlerinin ise nefropati evresiyle korelasyonu izlenmiştir. Sonuç: Diabetik hastalarda, ilerleyen nefropati ile birlikte ultrasonografik olarak parenkim kalınlıkları anlamlı olarak değişmezken, eko şiddetinde artma ve sağlıklı bireylere göre böbrek boyutlarında azalma gerçekleşmektedir.

Correlation of renal B-mode ultrasonographic findings with diabetic nephropathy stage

Aim: We aimed to investigate the renal morphological features detected by B-mode ultrasonography (US) in various clinical stages of diabetic nephropathy by means of a control group. Methods: As control group, 20 healthy person were selected. As study group, 69 patients with type-2 diabetes were included. All cases in both groups were evaluated with B-mode US in terms of renal length, parenchymal thickness and echogenicity. Diabetic patients were divided into 3 groups according to 24-hour urinary albumin excretion ratios (AER) (Group-1: AER<30 mg/ day; Group-2: AER 30-300 mg/ day; Group-3: AER >300 mg/ day); and mean renal parenchymal thickness and length were measured. By SPSS programme, mean values were compared between groups. Results: When mean renal length was compared between control and study groups, significant difference was noticed; but when mean renal parenchymal thickness was compared, no significant difference was demonstrated between two groups. When study groups were compared between each other,no statistically significant difference was seen. Cortical hyperechogenicity ratios; mean serum BUN and creatinine clearance rates, were correlated with nephropathy stage. Conclusion: With progression of nephropathy in diabetic patients,renal parenchymal thickness do not significantly differ; but hyperechogenicity and decrease in renal dimensions (control versus study group) occur.

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