Simeone Andrulli, Antonietta Gigante, Michele Rossini, Pierluigi D’Angio’, Gisella Vischini, Franca Luchetta, Filippo Aucella, Giovanni Valsecchi, Barbara Infante, Maria Giovanna Vario, Domenico Giannese, Antonio Granata, Elisabetta Moggia, Guido Gembillo, Rosario Cianci, Mario Bonomini, Flavia Manenti, Roberta Lazzarin, Brigida Di Renzo, Fulvia Zanchelli, Maurizio Garozzo, Massimo Manes, Yuri Battaglia, Raffaela Sciri, Marco De Fabritiis, Marco Quaglia, Gioacchino Li Cavoli, Enrica Gintoli, Maria Maddalena Conte, Maurizio Borzumati, Luisa Benozzi, Giovanna Pasquariello, Giovanni Andrulli, Marco Leoni, Giuseppe Seminara, Valentina Corbani, Gianmarco Sabiu, Arcangelo Di Maggio, Rosa Maria Pollastro, Loreto Gesualdo
{"title":"How histopathological diagnosis interacts with kidney ultrasound parameters and glomerular filtration rate","authors":"Simeone Andrulli, Antonietta Gigante, Michele Rossini, Pierluigi D’Angio’, Gisella Vischini, Franca Luchetta, Filippo Aucella, Giovanni Valsecchi, Barbara Infante, Maria Giovanna Vario, Domenico Giannese, Antonio Granata, Elisabetta Moggia, Guido Gembillo, Rosario Cianci, Mario Bonomini, Flavia Manenti, Roberta Lazzarin, Brigida Di Renzo, Fulvia Zanchelli, Maurizio Garozzo, Massimo Manes, Yuri Battaglia, Raffaela Sciri, Marco De Fabritiis, Marco Quaglia, Gioacchino Li Cavoli, Enrica Gintoli, Maria Maddalena Conte, Maurizio Borzumati, Luisa Benozzi, Giovanna Pasquariello, Giovanni Andrulli, Marco Leoni, Giuseppe Seminara, Valentina Corbani, Gianmarco Sabiu, Arcangelo Di Maggio, Rosa Maria Pollastro, Loreto Gesualdo","doi":"10.1007/s11739-024-03711-7","DOIUrl":null,"url":null,"abstract":"<p>The evaluation of estimated GFR (eGFR) is a pivotal staging step in patients with chronic kidney disease (CKD), and renal ultrasound plays an important role in diagnosis, prognosis and progression of CKD. The interaction between histopathological diagnosis and ultrasound parameters in eGFR determination has not been fully investigated yet. The study examined the results of native kidney biopsies performed in 48 Italian centers between 2012 and 2020. The primary goal was if and how the histopathological diagnosis influences the relationship between ultrasound parameters and eGFR. After exclusion of children, patients with acute kidney injury and patients without measure of kidney length or parenchymal thickness, 2795 patients have been selected for analysis. The median values were 52 years for patient age, 11 cm for bipolar kidney diameter, 16 mm for parenchymal thickness, 2.5 g/day for proteinuria and 70 ml/min/1.73 m<sup>2</sup> for eGFR. The bipolar kidney diameter and the parenchymal thickness were directly related with eGFR values (R square 0.064). Diabetes and proteinuria were associated with a consistent reduction of eGFR, improving the adjusted R square up to 0.100. Addition of histopathological diagnosis in the model increased the adjusted R square to 0.216. There is a significant interaction between histopathological diagnosis and longitudinal kidney diameter (<i>P</i> 0.006). Renal bipolar length and parenchymal thickness are directly related with eGFR. The magnitude of proteinuria and histopathological kidney diagnosis are associated with eGFR. The relationship between kidney length and the level of eGFR depends on the nature of the kidney disease.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Internal and Emergency Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11739-024-03711-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
The evaluation of estimated GFR (eGFR) is a pivotal staging step in patients with chronic kidney disease (CKD), and renal ultrasound plays an important role in diagnosis, prognosis and progression of CKD. The interaction between histopathological diagnosis and ultrasound parameters in eGFR determination has not been fully investigated yet. The study examined the results of native kidney biopsies performed in 48 Italian centers between 2012 and 2020. The primary goal was if and how the histopathological diagnosis influences the relationship between ultrasound parameters and eGFR. After exclusion of children, patients with acute kidney injury and patients without measure of kidney length or parenchymal thickness, 2795 patients have been selected for analysis. The median values were 52 years for patient age, 11 cm for bipolar kidney diameter, 16 mm for parenchymal thickness, 2.5 g/day for proteinuria and 70 ml/min/1.73 m2 for eGFR. The bipolar kidney diameter and the parenchymal thickness were directly related with eGFR values (R square 0.064). Diabetes and proteinuria were associated with a consistent reduction of eGFR, improving the adjusted R square up to 0.100. Addition of histopathological diagnosis in the model increased the adjusted R square to 0.216. There is a significant interaction between histopathological diagnosis and longitudinal kidney diameter (P 0.006). Renal bipolar length and parenchymal thickness are directly related with eGFR. The magnitude of proteinuria and histopathological kidney diagnosis are associated with eGFR. The relationship between kidney length and the level of eGFR depends on the nature of the kidney disease.
期刊介绍:
Internal and Emergency Medicine (IEM) is an independent, international, English-language, peer-reviewed journal designed for internists and emergency physicians. IEM publishes a variety of manuscript types including Original investigations, Review articles, Letters to the Editor, Editorials and Commentaries. Occasionally IEM accepts unsolicited Reviews, Commentaries or Editorials. The journal is divided into three sections, i.e., Internal Medicine, Emergency Medicine and Clinical Evidence and Health Technology Assessment, with three separate editorial boards. In the Internal Medicine section, invited Case records and Physical examinations, devoted to underlining the role of a clinical approach in selected clinical cases, are also published. The Emergency Medicine section will include a Morbidity and Mortality Report and an Airway Forum concerning the management of difficult airway problems. As far as Critical Care is becoming an integral part of Emergency Medicine, a new sub-section will report the literature that concerns the interface not only for the care of the critical patient in the Emergency Department, but also in the Intensive Care Unit. Finally, in the Clinical Evidence and Health Technology Assessment section brief discussions of topics of evidence-based medicine (Cochrane’s corner) and Research updates are published. IEM encourages letters of rebuttal and criticism of published articles. Topics of interest include all subjects that relate to the science and practice of Internal and Emergency Medicine.