# Role of Renal Resistive Index as an Early Marker of Diabetic Nephropathy in Children With Type 1 Diabetes Mellitus

## TL;DR

This study shows that the renal resistive index (RRI) can detect early signs of kidney damage in children with type 1 diabetes before traditional markers like albuminuria appear.

## Contribution

The study demonstrates that RRI can serve as an early non-invasive marker for diabetic nephropathy in children with type 1 diabetes.

## Key findings

- RRI >=0.7 was found in 12.2% of children with T1DM, indicating early kidney damage.
- RRI correlates with urine albumin excretion and occurs before albuminuria reaches diagnostic thresholds.
- Older age, longer diabetes duration, and higher cholesterol levels are risk factors for diabetic nephropathy.

## Abstract

Objective

Diabetic nephropathy (DN) is the most common microvascular complication in type 1 diabetes mellitus (T1DM). The study aimed to assess the role of renal resistive index (RRI) in early detection of DN in children with T1DM.

Methods

This study was conducted on 122 children with T1DM. The following parameters were studied: age, gender of patients, duration of diabetes, number of diabetic ketoacidosis (DKA) episodes, serum creatinine, serum urea, urine albumin excretion (UAE), glycated hemoglobin (HBA1c) and mean RRI of both kidneys.

Results

The study included 60 (49%) males and 62 (51%) females; with male to female ratio 0.96:1; their mean ages were 9.5 ± 2.89 years (range, 5-14) years and mean disease duration was 3.7 ± 1.6 years (range, 2-10) years; mean value of HBA1c was 11.69 ± 2.1 and 88.5% (108) of cases with T1DM in our study were normoalbuminuric and only 11.4% (14) of cases had albuminuria. The RRI >=0.7 (indicative of DN) was found in 12.2% (15) cases of T1DM in our study. Risk factors significantly associated with DN were age of children (older ages more affected), longer duration of disease, and higher total cholesterol and triglycerides levels. The cases of T1DM with UAE >30 mg/24 hours as well as RRI >=0.7 had significantly higher mean blood urea and serum creatinine levels indicating renal involvement.

Conclusion

RRI values significantly correlates with renal UAE. RRI abnormality occurs even before the level of UAE reaches the cut-off value of early diagnosis of DN. Hence, RRI (>=0.7) can be used as an early indicator of DN.