Comparison of renal resistive index among patients with Type 2 diabetes with different levels of creatinine clearance and urinary albumin excretion

Diabet. Med. 29, 10431046 (2012) Aim To evaluate the prevalence of increased renal resistive index and related factors among patients with Type 2 diabetes with different levels of creatinine clearance and urinary albumin excretion. Methods Laboratory analyses, including calculation of 24-h urinary albumin excretion and 24-h creatinine clearance, and renal doppler ultrasonography to measure renal resistive index, were carried out for patients newly diagnosed with Type 2 diabetes mellitus. Results Participants were classified into four groups according to 24-h creatinine clearance and 24-h urinary albumin excretion levels. Group 1 was composed of 73 patients (54.1%) with normal 24-h creatinine clearance and 24-h urinary albumin excretion. Group 2 was composed of 34 (25.2%) patients with normal 24-h creatinine clearance and increased 24-h urinary albumin excretion. Group 3 was composed of 14 (10.4%) patients with decreased 24-h creatinine clearance and normal 24-h urinary albumin excretion. Group 4 was composed of 14 (10.4%) patients with both decreased 24-h creatinine clearance and increased 24-h urinary albumin excretion . In total, 41 patients (30.4%) had increased renal resistive index levels. Comparison of the four groups with respect to increased renal resistive index revealed: among group 1 patients, 10 (13.7%) had increased renal resistive index levels; among group 2 patients, 14 (41.2%) had increased renal resistive index levels; among group 3 patients, eight (57.1%) had increased renal resistive index levels; among group 4 patients, nine (64.3%) had increased renal resistive index levels (P < 0.0001 for trend). In multivariate regression, 24-h creatinine clearance (P < 0.0001), but not 24-h urinary albumin excretion, was related to increased renal resistive index levels. Conclusion Renal resistive index levels were highest in patients with Type 2 diabetes with both decreased 24-h creatinine clearance and increased 24-h urinary albumin excretion, whereas they were lowest in patients with normal creatinine clearance and normal urinary albumin excretion.