Co-RELATION OF RENAL PARENCHYMAL DISEASE WITH THE SEVERITY OF RENAL DYSFUNCTION

Abstract

Background: Renal parenchymal disease (RPD) is a common cause of chronic kidney dysfunction, with diagnosis and monitoring traditionally reliant on serum biomarkers such as creatinine and estimated glomerular filtration rate (eGFR). However, these markers are influenced by non-pathological factors including age, sex, and body mass index, limiting their reliability in isolation. Ultrasonography offers a non-invasive method for evaluating renal parenchymal architecture and has emerged as a valuable adjunct in assessing the severity and progression of renal impairment.

Objective: To evaluate the correlation between ultrasonographic grading of RPD and renal function measured by eGFR.

Methods: This cross-sectional observational study was conducted at Combined Military Hospital (CMH) Multan over a nine-month period from March to December 2024. A total of 100 patients aged 18 years and above, with radiologically confirmed RPD and laboratory evidence of renal dysfunction, were enrolled. Exclusion criteria included obstructive uropathy, reversible acute kidney injury, congenital renal anomalies, or inability to consent. Each patient underwent renal ultrasonography for parenchymal grading (Grade I–IV) and laboratory evaluation of serum creatinine, blood urea nitrogen (BUN), and eGFR. CKD staging was done based on eGFR ranges. Spearman’s correlation was applied to assess the relationship between RPD grade and eGFR.

Results: The mean age was 54.2 ± 12.7 years, with 62% male representation. Hypertension and diabetes mellitus were present in 70% and 58% of patients, respectively. Grade III and IV RPD were noted in 35% and 20% of patients, respectively. eGFR declined progressively with increasing RPD severity: Grade I (72.5 ± 10.2), Grade II (54.3 ± 8.7), Grade III (32.4 ± 7.9), and Grade IV (18.1 ± 6.4 mL/min/1.73 m²). A strong inverse correlation between RPD grade and eGFR was found (Spearman’s ρ = -0.82, p < 0.001). Most patients (75%) fell within CKD Stages 3–5.

Conclusion: There is a statistically significant inverse relationship between ultrasound-detected RPD grade and renal function as measured by eGFR. The integration of imaging and biochemical evaluation provides a comprehensive, non-invasive strategy for assessing and monitoring renal disease.