Point Shear Wave Elastography (pSWE) for Evaluating Chronic Kidney Disease (CKD) in Adult Native Kidney with Histopathological Correlation

Abstract

Purpose: The purpose of this study was to examine the utility of point shear wave elastography
(pSWE) in the diagnosis of chronic kidney disease (CKD) and the assessment of the degree of renal
fibrosis.
Materials and methods: This study was performed at the Radiodiagnosis Department, Zagazig
University. We examined 21 CKD patients who underwent renal biopsy and 21 healthy volunteers with
conventional ultrasound and pSWE.Patients were classified according to the degree of renal fibrosis
into four groups: non-fibrosis, mild, moderate, or severe fibrosis. All analyses were done using the
Statistical Package for theSocial Sciences 20.0 software.
Results: The mean value of SWE (kPa) in patients (5.44±1.4) was more than (P=0.0001) that of
healthy volunteers (2.5±1.00). The mean SWE values in the CKD stages were 3.65±0.9, 4.5±1.2,
5.8±0.5, 5.3±1.1, 6.6±0.9 kPa in stages 1,2,3,4, and 5 respectively. There was no significant difference
between CKD stages except between stage 1 vs. 5 and stage 2 vs. 5. Only age showed a significant
correlation with SWE in both CKD patients (r=0.453; P=0.039) and healthy volunteers (r=0.497;
P=0.022). The histopathology revealed that 6 patients showed no fibrosis (4.0±1.1kPa), 11 patients
showed mild fibrosis (6.0±1.0kPa), and 4 patients showed moderate fibrosis (5.9±1.2kPa), while no
patients showed severe fibrosis. The cut-off value for predicting CKD was 4.05 kPa with 85.70%
sensitivity and 90.5% specificity, while for predicting kidney fibrosis it was 4.45 kPa with a 93.30%
sensitivity and 83.3% specificity.
Conclusion: Our findings imply that SWE is capable of discriminating between normal participants
and patients with chronic kidney disease. Additionally, it is capable of detecting kidney fibrosis.