Chronic kidney disease: sonographic/clinical findings at the University Of Benin Teaching Hospital

Abstract

Introduction: Kidney disease arises from various causes which can lead to death, especially if it progresses to chronic renal disease. Some of these patients can be managed by the use of conservative management, drugs, dialysis or renal transplantation depending on several factors. Amongst several investigative methods (clinical, laboratory and radiological), ultrasound plays an important role. The dimensions of the kidneys, its sonographic appearances and Doppler characteristics are useful in assessing the kidneys. Consequently correlating sonographic and clinical findings in CKD patients may yield useful information.

Methods: The study is a cross-sectional descriptive type that involves 35 CKD patients. These patients were being managed for CKD and were referred for renal scan as part of their management. Theirserum creatinine values were used to categorize them into CKD stages using the MDRD formula for eGFR estimation. The sonographic findings were then correlated with the CKD stages. Statistical analysis was done using SPSS version 20.

Results: The mean age of the participant was 41.8 years with the age ranging from 20 to 72 years. The mean serum creatinine value was creatinine 4.0±1.8mg/dL. Participants with severe CKD stage had the highest proportion of renomegaly with 69.2% on the right and 75% on the left. However, 100% of shrunken kidneys were seen in the severe and very severe stages only in both kidneys. There were 88.9% of patients in the severe CKD stage with increased renal cortical echogenicity (grade III).

Conclusion: Renal sonographic findings in CKD may be used to determine the progress of the disease, although normal sonographic findings may be seen in cases of very severe CKD stage.

Keywords: CKD, CKD staging, renomegaly, renal echogenicity, renal dimensions, renal volume, proteinuria