World J Nephrol Urol

World Journal of Nephrology and Urology, ISSN 1927-1239 print, 1927-1247 online, Open Access

Article copyright, the authors; Journal compilation copyright, World J Nephrol Urol and Elmer Press Inc

Journal website http://www.wjnu.org

Original Article

Volume 1, Number 4-5, October 2012, pages 107-114

Clinical Profile of Diabetic Nephropathy and Correlation With Intrarenal Resistivity Index by Duplex Ultrasonography

**Table 1.** Risk Factors for Diabetic Nephropathy and IRI
Risk factor	Group I IRI ≤ 0.70 (n = 72)	Group II IRI > 0.70 (n = 88)	Odds ratio	CI	P value
Smoking	15 (20.83%)	32 (36.36%)	2.171	1.062 - 4.442	0.032^*
Alcohol	22 (30.56%)	30 (34.09%)	1.176	0.603 - 2.292	0.635
Hypertension	17 (23.61%)	48 (54.55%)	3.882	1.953 - 7.717	< 0.001^*
Family h/o DM	11 (15.28%)	18 (20.45%)	1.426	0.625 - 3.254	0.523
Family h/o DM nephropathy	04 (8.33%)	12 (13.64%)	2.684	0.826 - 8.718	0.153
Obesity	28 (38.89%)	50 (56.82%)	2.068	1.096 - 3.899	0.036^*
Dyslipidemia	22 (30.56%)	53 (60.23%)	3.442	1.781 - 6.649	< 0.001^*

Table 1. Risk Factors for Diabetic Nephropathy and IRI

Risk factor

Group I IRI ≤ 0.70 (n = 72)

Group II IRI > 0.70 (n = 88)

Odds ratio

P value

Smoking

15 (20.83%)

32 (36.36%)

2.171

1.062 - 4.442

0.032^*

Alcohol

22 (30.56%)

30 (34.09%)

1.176

0.603 - 2.292

0.635

Hypertension

17 (23.61%)

48 (54.55%)

3.882

1.953 - 7.717

< 0.001^*

Family h/o DM

11 (15.28%)

18 (20.45%)

1.426

0.625 - 3.254

0.523

Family h/o DM nephropathy

04 (8.33%)

12 (13.64%)

2.684

0.826 - 8.718

0.153

Obesity

28 (38.89%)

50 (56.82%)

2.068

1.096 - 3.899

0.036^*

Dyslipidemia

22 (30.56%)

53 (60.23%)

3.442

1.781 - 6.649

< 0.001^*

**Table 2.** Symptoms of Diabetic Nephropathy in Group I and II
SR NO	Symptoms	Group I IRI ≤ 0.70 (n = 72)	Group II IRI > 0.70 (n = 88)	Odds ratio	CI	P value
1	Symptomatic	26 (36.11%)	69 (78.41%)	6.425	3.193 - 12.931	0.000^*
2	Edema feet	02 (2.77%)	34 (38.63%)	22.037	5.069 - 95.809	< 0.001^*
3	Anasarca	Nil	11 (12.5%)	-	-	0.005^*
4	Polyuria	18 (25%)	28 (31.18)	1.4	0.697 - 2.811	0.440
5	Oliguria	02 (2.77%)	15 (17.05%)	7.192	1.586 - 32.602	0.004^*
6	Breathlessness	05 (6.94%)	38 (43.18%)	10.184	3.740 - 27.733	< 0.001^*
7	Abdominal distension	06 (8.33%)	35 (39.77%)	7.484	2.931 - 19.113	< 0.001^*
8	Convulsions	Nil	06 (6.82%)	-	-	0.06
9	Altered sensorium	Nil	08 (9.09%)	-	-	0.024^*

Table 2. Symptoms of Diabetic Nephropathy in Group I and II

SR
NO

Symptoms

Group I IRI ≤ 0.70 (n = 72)

Group II IRI > 0.70 (n = 88)

Odds ratio

P value

Symptomatic

26 (36.11%)

69 (78.41%)

6.425

3.193 - 12.931

0.000^*

Edema feet

02 (2.77%)

34 (38.63%)

22.037

5.069 - 95.809

< 0.001^*

Anasarca

Nil

11 (12.5%)

0.005^*

Polyuria

18 (25%)

28 (31.18)

1.4

0.697 - 2.811

0.440

Oliguria

02 (2.77%)

15 (17.05%)

7.192

1.586 - 32.602

0.004^*

Breathlessness

05 (6.94%)

38 (43.18%)

10.184

3.740 - 27.733

< 0.001^*

Abdominal distension

06 (8.33%)

35 (39.77%)

7.484

2.931 - 19.113

< 0.001^*

Convulsions

Nil

06 (6.82%)

0.06

Altered sensorium

Nil

08 (9.09%)

0.024^*

**Table 3.** Complications of Diabetes
Complication	Group I IRI ≤ 0.70 (n = 72)	Group II IRI > 0.70 (n = 88)	Odds ratio	CI	P value
Nil	50 (69.44%)	18 (20.45%)	8.83	4.289 - 18.175	0.000^*
CAD	01 (1.39%)	17 (19.32%)	17.0	2.203 - 131.195	< 0.001^*
Retinopathy	20 (27.78%)	70 (79.54%)	10.11	4.868 - 21.001	< 0.001^*
Background	19	48
Proliferative	01	22
Neuropathy	07 (9.72%)	36 (40.90%)	6.429	2.645 - 15.623	< 0.001^*
PVD	07 (9.72%)	16 (18.18%)	2.063	0.799 - 5.332	0.129

Table 3. Complications of Diabetes

Complication

Group I IRI ≤ 0.70 (n = 72)

Group II IRI > 0.70 (n = 88)

Odds ratio

P value

Nil

50 (69.44%)

18 (20.45%)

8.83

4.289 - 18.175

0.000^*

CAD

01 (1.39%)

17 (19.32%)

17.0

2.203 - 131.195

< 0.001^*

Retinopathy

20 (27.78%)

70 (79.54%)

10.11

4.868 - 21.001

< 0.001^*

Background

Proliferative

Neuropathy

07 (9.72%)

36 (40.90%)

6.429

2.645 - 15.623

< 0.001^*

PVD

07 (9.72%)

16 (18.18%)

2.063

0.799 - 5.332

0.129

**Table 4.** Urinalysis and Findings on Renal Ultrasound
Investigations	Group I IRI ≤ 0.70 (n = 72)	Group II IRI > 0.70 (n = 88)	Odds ratio	CI	P value
Urine RBC	03 (4.17%)	22 (25%)	7.667	2.191 - 26.829	0.001^*
Sugar	32 (44.44%)	30 (34.09%)	0.647	0.341 - 1.227	0.181
Microalbuminuria	58 (80.55%)	15 (17.05%)	0.05	0.022 - 0.111	< 0.001^*
Overt proteinuria	14 (19.44%)	73 (82.95%)	20.162	9.007 - 45.134	< 0.001^*
Renal sonography Kidney size
Right kidney size	9.7 × 5.3 cm	8.5 × 4.4 cm
left kidney size	9.4 × 5.1 cm	8.3 × 4.5 cm
Echotexture
1. Normal	71 (88.88%)	69 (78.40%)	0.051	0.007 - 0.303	< 0.001^*
2. Raised	01 (11.11%)	19 (21.60%)
CMD
1. Normal	70 (97.20%)	76 (86.36%)	0.181	0.039 - 0.837	0.033^*
2. Altered	02 (2.77%)	2 (2.27%)
3. Lost	-	10 (11.36%)

Table 4. Urinalysis and Findings on Renal Ultrasound

Investigations

Group I IRI ≤ 0.70 (n = 72)

Group II IRI > 0.70 (n = 88)

Odds ratio

P value

Urine RBC

03 (4.17%)

22 (25%)

7.667

2.191 - 26.829

0.001^*

Sugar

32 (44.44%)

30 (34.09%)

0.647

0.341 - 1.227

0.181

Microalbuminuria

58 (80.55%)

15 (17.05%)

0.05

0.022 - 0.111

< 0.001^*

Overt proteinuria

14 (19.44%)

73 (82.95%)

20.162

9.007 - 45.134

< 0.001^*

Renal sonography Kidney size

Right kidney size

9.7 × 5.3 cm

8.5 × 4.4 cm

left kidney size

9.4 × 5.1 cm

8.3 × 4.5 cm

Echotexture

1. Normal

71 (88.88%)

69 (78.40%)

0.051

0.007 - 0.303

< 0.001^*

2. Raised

01 (11.11%)

19 (21.60%)

CMD

1. Normal

70 (97.20%)

76 (86.36%)

0.181

0.039 - 0.837

0.033^*

2. Altered

02 (2.77%)

2 (2.27%)

3. Lost

10 (11.36%)

**Table 5.** Kidney Function Test and IRI
	Group I IRI ≤ 0.70	Group II IRI > 0.70	P value
Mean blood urea (mg/dL)	31.98 ± 8.99	49.84 ± 22.65	< 0.001^*
Mean Sr. creat (mg/dL)	0.99 ± 0.35	2.29 ± 1.46	< 0.001^*
Creatinine clearance (mL/min)	80.33 ± 27.01	39.72 ± 22.37	< 0.001^*
Mean blood sugar fasting (mg/dL)	101.94 ± 22.13	98.29 ± 21.2	0.290
Mean blood sugar post meal (mg/dL)	152.85 ± 31.12	153.86 ± 30.31	0.836

Table 5. Kidney Function Test and IRI

Group I IRI ≤ 0.70

Group II IRI > 0.70

P value

Mean blood urea (mg/dL)

31.98 ± 8.99

49.84 ± 22.65

< 0.001^*

Mean Sr. creat (mg/dL)

0.99 ± 0.35

2.29 ± 1.46

< 0.001^*

Creatinine clearance (mL/min)

80.33 ± 27.01

39.72 ± 22.37

< 0.001^*

Mean blood sugar fasting (mg/dL)

101.94 ± 22.13

98.29 ± 21.2

0.290

Mean blood sugar post meal (mg/dL)

152.85 ± 31.12

153.86 ± 30.31

0.836

**Table 6.** Multiple Linear Regression Analysis of Various Factors Affecting IRI
Model	Unstandardized Coefficients	Standardized Coefficients	t	Sig.
(Constant)	0.661	0.069		9.634	0.000
Age	0.002	0.011	0.124	1.648	0.042^*
Smoking	0.002	0.011	0.007	0.166	0.869
Hypertension	0.023	0.011	0.100	2.045	0.043^*
Dyslipidemia	-0.012	0.011	-0.053	-1.083	0.281
Obesity	-0.001	0.001	-0.037	-0.814	0.417
CAD	0.029	0.016	0.185	1.776	0.038^*
Neuropathy	-0.006	0.014	-0.024	-0.432	0.667
Macroalbumin	-0.055	0.015	-0.247	-3.730	0.000^*
Urine RBC	-0.010	0.013	-0.033	-0.727	0.469
PSV	0.072	0.013	0.323	5.740	0.000^*
Echotexture	0.023	0.019	0.082	1.246	0.215
CMD	0.048	0.033	0.114	1.439	0.152
Retinopathy	-0.045	0.013	-0.132	-2.565	0.048^*
Bld urea	0.000	0.001	0.025	0.244	0.808
Sr.creat	0.035	0.013	0.279	1.517	0.006^*
GFR	0.040	0.070	-0.092	-1.066	0.045^*

Table 6. Multiple Linear Regression Analysis of Various Factors Affecting IRI

Model

Unstandardized Coefficients

Standardized Coefficients

Sig.

Std. Error

Beta

(Constant)

0.661

0.069

9.634

0.000

Age

0.002

0.011

0.124

1.648

0.042^*

Smoking

0.002

0.011

0.007

0.166

0.869

Hypertension

0.023

0.011

0.100

2.045

0.043^*

Dyslipidemia

-0.012

0.011

-0.053

-1.083

0.281

Obesity

-0.001

0.001

-0.037

-0.814

0.417

CAD

0.029

0.016

0.185

1.776

0.038^*

Neuropathy

-0.006

0.014

-0.024

-0.432

0.667

Macroalbumin

-0.055

0.015

-0.247

-3.730

0.000^*

Urine RBC

-0.010

0.013

-0.033

-0.727

0.469

PSV

0.072

0.013

0.323

5.740

0.000^*

Echotexture

0.023

0.019

0.082

1.246

0.215

CMD

0.048

0.033

0.114

1.439

0.152

Retinopathy

-0.045

0.013

-0.132

-2.565

0.048^*

Bld urea

0.000

0.001

0.025

0.244

0.808

Sr.creat

0.035

0.013

0.279

1.517

0.006^*

GFR

0.040

0.070

-0.092

-1.066

0.045^*