Doppler ultrasonography: a tool for nephrologists--single centre experience.

Colour Doppler duplex ultrasonography (CDUS) has allowed noninvasive assessment of alterations of vascular perfusion showing general perfusion in colour. Since 1996, ultrasound examination by a duplex Doppler apparatus has been performed with an HDI 3000, ATL machine. We have retrospectively evaluated all patients (pts) with colour Doppler duplex examination for the last three years. Resistive indexes (RIs) are measured in each kidney using the existing software capabilities of the scanner. A total of 2581 CDUS examinations were performed over the past three years; in 2005 - 883 pts, in 2006 - 908 pts and in 2007 - 790 pts. Most of these examinations were on transplant pts. In 98 cases we examinated chronic rejection reactions, in 58 cases acute rejection and in 38 cases we postulated renal artery stenosis or thrombosis. We used CDUS to determine whether the RI can be used as a predictor in pts with Diabetic Nephropathy; in 108 cases we found an increased RI > 0.68. There is a positive correlation between the RI and the severity of arteriolosclerosis in the majority of pts, 331, where we found nephroarteriolosclerosis (RI > 0.64). In 52 cases renal artery stenosis was suspected (0.04 differences between RI on right and left renal artery). Acute renal failure was suspected in 53 cases. According to neoplasms, pathological, marked increased vascularization was noticed in 34 cases suspected for renal carcinoma, in 46 cases suspected of testicular tumours, 19 cases suspected of prostate neoplasm and in 32 cases suspected of tumours in other localizations. In combination with patient history, clinical and laboratory examination CDUS provides very useful information in accomplishing the diagnosis.