Role of Renal Elastography for the Early Detection of Childhood Glomerulonephritis.

Abstract

Introduction: Glomerulonephritis is a frequent childhood renal disease, that has diverse underlying etiologies. It has an underlying immunologic mechanism in most cases.Aim of the study: To evaluate renal elastography performance as a diagnostic tool for the early detection of acute childhood glomerulonephritis (AGN) and to determine its role in differentiation of different subtypes of AGN.Methods: This prospective research performed on eighty children separated into 2 groups: Group I: forty cases with clinical and laboratory evidence of glomerulonephritis and Group II: 40 healthy volunteers of comparable age and sex as controls at our University Children Hospital, Paediatric Nephrology Unit from January 2021 to December 2022. Acoustic radiation force impulse (ARFI) elastography was performed to analyse both kidneys in all participantsResults: The comparison of cases &control groups revealed a significant elevation in acoustic radiation force impulse elastography (ARFI-e) measurement values (p<0.001). By using Receiver operating characteristic (ROC) curve analysis, renal elastography can differentiate acute glomerulonephritis from normal at cut off 3.98 with sensitivity, specificity, PPV & NPV were 100%, 92.5%, 93% & 100% respectively (p< 0.001). However, no significant difference in ARFI-e measurement values was found between different types of glomerulonephritis in case group (p>0.05).Conclusion: As a bedside easily applicable, non-invasive method for the early detection of acute glomerulonephritis in children, the ARFI-e technique showed promising results that needs further investigation on larger number of different types of AGN. Key words: ARFI-e, Glomerulonephritis, SWS, Elastography