Shear wave elastography accurately detects chronic changes in renal histopathology

• Main Authors: Leong, Sook Sam, Wong, Jeannie Hsiu Ding, Md Shah, Mohammad Nazri, Vijayananthan, Anushya, Jalalonmuhali, Maisarah, Chow, Tak Kuan, Sharif, Nur H. M., Ng, Kwan Hoong
• Format: Article
• Published: Wiley 2021
• Subjects: R Medicine (General); RC Internal medicine
• Online Access: http://eprints.um.edu.my/34069/
• Institution: Universiti Malaya

Aim Renal biopsy is the gold standard for the histological characterization of chronic kidney disease (CKD), of which renal fibrosis is a dominant component, affecting its stiffness. The aim of this study was to investigate the correlation between kidney stiffness obtained by shear wave elastography (SWE) and renal histological fibrosis. Methods Shear wave elastography assessments were performed in 75 CKD patients who underwent renal biopsy. The SWE-derived estimates of the tissue Young's modulus (YM), given as kilopascals (kPa), were measured. YM was correlated to patients' renal histological scores, broadly categorized into glomerular, tubulointerstitial and vascular scores. Results Young's modulus correlates significantly with tubulointerstitial score (rho= 0.442,P < .001) and glomerular score (rho= 0.375,P= .001). Patients with no glomerular sclerosis showed lower mean YM measurements compared to those with glomerular sclerosis. The mean YM increased as the percentage of interstitial fibrosis and tubular atrophy increased. The area under the receiver operating characteristic curve (ROC) for SWE in differentiating between mildly and moderately impaired kidneys was 0.702. Conclusion Shear wave elastography accurately detects chronic renal damage resulting from glomerular sclerosis, interstitial fibrosis and tubular atrophy, using the optimal cut-off YM value of >= 5.81 kPa.