INTRARENAL HAEMODYNAMIC IN TYPE 2 DIABETIC S MELLITUS AND ITS CORRELATION WITH BIOCHEMICAL PARAMETERS
Journal of Evolution of Medical and Dental Sciences
AIMS & OBJECTIVES: The evaluation of resistance index of interlobar artery on Color Doppler imaging in type 2 diabetes mellitus patients and comparison with healthy controls and the Correlation among Colour Doppler sonographic findings and biochemical parameters in type 2 diabetic patients. MATERIALS AND METHODS: 200 patients with type 2 diabetes mellitus and 30 healthy controls were included in this study. The resistive index of interlobar renal arteries was used to assess the internal
... he internal haemodynamic changes in diabetic patients as compared to normal subjects. RESULTS: The patients were divided into four groups: Group I: consisted of patients with 24 hour urinary protein less than 30 mg per ml; Group II: 30 to 300 mg per ml, Group III: more than 300 mg per ml and Group IV: serum creatinine more than or equal to 1.5mg per dl. The mean of intrarenal RI value was 0.66+.21 in controls, 0.69.42 in group I, 0.72.24 in group II, 0.76.34 in group III and 0.84.35 in group IV. RI values in group II, III and IV were significantly higher than those in controls (p<.0.001). And those in group IV were significantly higher than those in group I, II and III. Also, there was a significant effect of duration of diabetes on intra renal hemodynamics with mean RI value 0.72+0.43 in patients with diabetes of less than 10 year duration and mean RI value of 0.78.0.34 in patients with diabetes more than 10 year duration. CONCLUSION: Type 2 diabetic patients have higher values of RI as compared to non-diabetics and this increment is proportional to the duration of diabetes. An intra renal RI value of >0.7 identifies diabetic patients at risk of progressive renal disease. Higher RI correlates to higher protein in urine and duration of diabetes in diabetic patients. Thus, an increasing intra-renal resistance index value could prompt the physician to a more tight control of blood sugars and hypertension in the group of diabetic patients, delaying the progression to end stage renal failure.