Relation between resistivity and pulsatility indices of renal and intrarenal arteries and degree of albuminuria in type 2 diabetic patients

Introduction: Macrovascular complications are well known in diabetes mellitus and diabetic nephropathy. This work aimed to study the relation between resistivity index (RI) and pulsatility index (PI) of the main renal and intrarenal arteries and the degree of albuminuria in diabetic patients. Patients and methods: The study included 60 type 2 diabetic patients with more than 5‑year duration of diabetes. There were 14 male and 46 female patients. They were divided into three groups: group I included patients with no albuminuria [albumin/creatinine ratio (ACR) in first voiding morning urine sample 30 mg/g creatinine]; group II included patients with microalbuminuria (ACR: 30–300 mg/g creatinine), and group III included patients with macroalbuminuria (ACR: ≥300 mg/g creatinine). Patients with fever, urinary tract infection, uncontrolled blood pressure, congestive heart failure, critically ill patients, or patients having other renal disease were excluded. All patients were subjected to measurement of ACR in the first voiding morning urine sample, serum creatinine, estimated glomerular filtration rate using Cockroft–Gault formula, and HbA1C. RI and PI of main renal and intrarenal arteries were measured on both sides using duplex Doppler ultrasonography. Results: RI and PI of renal and intrarenal arteries were found to be significantly higher in group III than in group II and group I, with group II patients having higher values compared with group I (P 0.001 for all). ACR was found to be positively correlated with RI and PI of all studied renal and intrarenal arteries (P 0.001 for all). Conclusion: In type 2 diabetes mellitus, RI and PI of renal arteries on duplex Doppler ultrasonography examination are related directly to the degree of albuminuria, which could serve as an indicator to the degree of resistance in renal arteries.