Renal Resistive Index Detects Early Diabetic Kidney Damage in Children with Type 1 Diabetes: Study

Researchers have found in a new study that the Renal Resistive Index (RRI) detects early diabetic kidney damage in children with Type 1 Diabetes Mellitus. The study, published in Cureus, highlights that in children with Type 1 Diabetes Mellitus, a Renal Resistive Index of 0.7 or higher can indicate early diabetic nephropathy even before urine albumin levels rise. Although 88.5% of the participants were normoalbuminuric (having normal levels of albumin in urine), 12.2% had elevated Renal Resistive Index values. Elevated Renal Resistive Index and urine albumin excretion were associated with increased blood urea and serum creatinine levels. Additionally, older age, a longer duration of diabetes, and abnormal lipid profiles (including high total cholesterol and triglyceride levels) were linked to a higher risk of developing diabetic nephropathy. Diabetic nephropathy is the most common microvascular complication in individuals with Type 1 Diabetes Mellitus. This study aimed to assess the role of the Renal Resistive Index in the early detection of diabetic nephropathy in children with Type 1 Diabetes Mellitus. The study was conducted on 122 children diagnosed with Type 1 Diabetes Mellitus. Researchers analyzed several parameters: the age and gender of patients, the duration of diabetes, the number of episodes of diabetic ketoacidosis, serum creatinine, serum urea, urine albumin excretion, glycated hemoglobin levels, and the mean Renal Resistive Index of both kidneys The study included 60 males (49%) and 62 females (51%), with a male-to-female ratio of 0.96:1. The participants’ mean age was 9.5 years (± 2.89), ranging from 5 to 14 years, and the average duration of the disease was 3.7 years (± 1.6), ranging from 2 to 10 years. The mean value of glycated hemoglobin was 11.69% (± 2.1). In this study, 88.5% (108 participants) were normoalbuminuric, while 11.4% (14 participants) had albuminuria. A Renal Resistive Index of 0.7 or higher—considered indicative of diabetic nephropathy—was observed in 12.2% (15 participants). The risk factors significantly associated with diabetic nephropathy were older age, longer disease duration, and higher total cholesterol and triglyceride levels. Children with urine albumin excretion above 30 milligrams per 24 hours and those with a Renal Resistive Index of 0.7 or higher had significantly higher mean blood urea and serum creatinine levels, indicating renal involvement. The Renal Resistive Index was found to significantly correlate with urine albumin excretion. Importantly, abnormalities in the Renal Resistive Index were observed even before urine albumin levels reached the threshold for early diagnosis of diabetic nephropathy. Therefore, a Renal Resistive Index of 0.7 or higher can be considered an early indicator of diabetic nephropathy in children with Type 1 Diabetes Mellitus.