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Background <p>Diabetic kidney disease (DKD) is a major complication of type 2 diabetes mellitus (T2DM), with proteinuria being a primary clinical marker. This study explores the renal resistive index (RA_RI), measured by Doppler ultrasound, as a non-invasive vascular biomarker for detecting and classifying proteinuria severity in T2DM patients.</p> Methods <p>A cross-sectional study was conducted on 100 patients with T2DM, equally divided into proteinuric and non-proteinuric groups. Clinical, biochemical, and Doppler ultrasonographic data were analyzed. Diagnostic performance of RA_RI was assessed using ROC analysis, regression models, and decision-curve analysis.</p> Results <p>RA_RI was significantly higher in proteinuric individuals (0.65 ± 0.03) compared to non-proteinuric individuals (0.58 ± 0.01, <i>p</i>&lt;0.001). At a cut-off of 0.605, RA_RI achieved 92% sensitivity and 100% specificity. RA_RI remained an independent predictor after adjustment. A positive correlation (<i>ρ</i> = 0.40, <i>p</i> = 0.0037) was found between RA_RI and mildly increased albuminuria, indicating early vascular involvement.</p> Conclusion <p>RA_RI is a promising adjunct for early and non-invasive identification of proteinuria and albuminuria progression in T2DM. Its integration may enhance DKD risk stratification when used alongside traditional markers.</p>

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Beyond glycemia: renal resistive index provides robust discrimination and incremental clinical utility for proteinuria in type 2 diabetes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月3日

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  • Elham Yousief,
  • Heba Mahmoud Ibrahim

摘要

Background

Diabetic kidney disease (DKD) is a major complication of type 2 diabetes mellitus (T2DM), with proteinuria being a primary clinical marker. This study explores the renal resistive index (RA_RI), measured by Doppler ultrasound, as a non-invasive vascular biomarker for detecting and classifying proteinuria severity in T2DM patients.

Methods

A cross-sectional study was conducted on 100 patients with T2DM, equally divided into proteinuric and non-proteinuric groups. Clinical, biochemical, and Doppler ultrasonographic data were analyzed. Diagnostic performance of RA_RI was assessed using ROC analysis, regression models, and decision-curve analysis.

Results

RA_RI was significantly higher in proteinuric individuals (0.65 ± 0.03) compared to non-proteinuric individuals (0.58 ± 0.01, p<0.001). At a cut-off of 0.605, RA_RI achieved 92% sensitivity and 100% specificity. RA_RI remained an independent predictor after adjustment. A positive correlation (ρ = 0.40, p = 0.0037) was found between RA_RI and mildly increased albuminuria, indicating early vascular involvement.

Conclusion

RA_RI is a promising adjunct for early and non-invasive identification of proteinuria and albuminuria progression in T2DM. Its integration may enhance DKD risk stratification when used alongside traditional markers.