[Ultrasonographic evaluation of kidneys in type-2 diabetes patients without overt nephropathy and with chronic renal failure].

Ultrasonographic evaluation of the kidney size is a useful method for assessment of the progression and in some cases the type of nephropathy. Diabetic nephropathy in type 2 diabetes is not only the cause of chronic renal failure (CRF), but also non-diabetic renal diseases. Besides giving the clinical picture, USG evaluation can be useful for qualification of the main cause of CRF in type 2 diabetes patients (pts). In the study we attempted to evaluate if type 2 diabetic pts without nephropathy have significant changes in the USG kidney picture compared with type 2 diabetic pts with CRF. The study was conducted on two groups of type 2 diabetic pts. Group I consisted of 44 pts (18 men, 26 women) without overt nephropathy with mean creatinine clearance (CrC) calculated by Cockcroft-Gault formula 78.7 +/- 3 ml/min. Group II consisted of 48 pts (23 men, 25 women) with CRF: 30 pts with mean CrC 25.8 +/- 2 ml/min and 18 CAPD (continuous ambulatory peritoneal dialysis) pts. The mean age was similar in both groups (62.5 vs 64.5). Small kidney was defined when USG kidney length was less than 9 cm. In Group I 33 pts (75%) had normal size kidneys, 11 pts (25%) had small kidneys with postinflammatory changes, and 3 pts had single cysts. In Group II 9 pts (18.8%) had normal size kidneys. We found small kidneys in 39 pts (81.2%) and single cyst in 7 pts (15%). None of the patients had acquired cystic kidney disease. In our study we found that most of type 2 diabetic pts with CRF had small kidneys which means that they had ischemic, hypertonic or inflammatory nephropathy accompanying type 2 diabetes.