Korean Journal of Nephrology 1993;12(2):144-150.

당뇨병 환자에서 신장저항계수 ( Renal resistive index ) 의 임상적

오제열 , 조한선 , 하성규 , 이호영 , 한대석 , 김경래 , 김기황 , 이연희

Abstract

Ultrasonography is often used as an initial imaging method in the examination of patients with renal dis- ease. Using doppler ultrasonography, it is possible to predict the vascular resistance of peripheral organs including kidney by calculating the resistive index (RI) of the doppler wave form. Diabetes mellitus is a sys- temic metabolic disease which frequently shows mi- crovascular lesions and is predicted to have increased renal vascular resistance. We measured doppler waves of renal arcuate artery in the 20 healthy volunteers and 25 diabetic patients using ultrasound of duplex image and calculated the RI of 2 groups to investigate clinical implications of the renal vascular resistance in diabetic patients. The results are as follows: 1) The RI of diabetic group (64.9±6.4%, Mean±S.D.) was significantly higher than that of control group (59. 0±4.9%, p<0.001). 2) The diabetic patients were divided into 2 groups; one is equal to or greater than 500 mg/24 hours and the other less than 500 mg/24 hours according to the amount of 24 hours urinary protein excretion. The RI of high protein excretion group (68.2±5.7%) was higher than that of low protein excretion group (62.8±6.2%, p<0. 05). 3) In diabetic patients, the RI positively correlated with the 24 hours urinary protein excretion amount, the serum BUN and creatinine respectively (r=0.6170, 0. 4632, 0.4682; p<0.001, p<0.01). However, a trend of negative correlation was revealed between the creatinine clearance and RI (r= 0.3769, p=0.0633). These results suggest that the RI of the diabetics is much higher than that of the healthy person, and it may be used as a non-invasive method representing the grade of diabetic nephropathy. But further studies with more cases are needed to clarify the above findings.