• Hilmi Erdem Sumbul, Ayse Selcan Koc, and Erdinç Gülümsek.
• Department of Internal Medicine, University of Health Sciences, Adana Health Practice and Research Center, Adana, Turkey.
• Singap Med J. 2020 Aug 1; 61 (8): 435442435-442.

IntroductionWe aimed to investigate changes in renal cortical stiffness (CS) in Type 2 diabetes mellitus (DM) and pre-DM patients compared to subjects with normal glucose metabolism (NGM), as well as the usefulness of renal CS to determine the presence of nephropathy.MethodsThis study included 125 individuals with NGM, pre-DM and Type 2 DM. Routine laboratory data was obtained, and micro- and macrovascular involvement were investigated. Urinary albumin-creatinine ratio (UACR) was measured for urinary albuminuria detection. In addition to routine renal ultrasonography, CS was measured using renal elastography.ResultsAmong the included patients, 42, 40 and 43 patients had NGM, pre-DM and Type 2 DM, respectively, with prevalence of nephropathy of 5%, 15% and 33%, respectively. Carotid and aortic intima-media thickness (IMT), renal width, and CS were found to be higher in the pre-DM and Type 2 DM groups than the NGM group. Aortic IMT, renal width and UACR levels were independently associated with CS. Patients with nephropathy were found to have a higher CS value than those without nephropathy (8.72 ± 1.67 kPa vs. 10.60 ± 1.74 kPa, p = 0.001). In receiver operating characteristic curve analysis, when the cut-off value for CS was taken as 9.2 kPa, renal CS predicted the possibility of nephropathy with 78.9% sensitivity and 71.4% specificity.ConclusionCS values are significantly higher in patients with impaired glucose metabolism. We recommend CS measurement as part of routine screening of nephropathy in patients with pre-DM and newly diagnosed Type 2 DM.Copyright: © Singapore Medical Association.

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