Diagnostic Role of Renal Doppler Ultrasound and Soluble Klotho in Early Detection of Diabetic Nephropathy in Children with Type 1 Diabetes Mellitus | ||
| Medicine Updates | ||
| Articles in Press, Accepted Manuscript, Available Online from 17 November 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/muj.2025.436596.1281 | ||
| Authors | ||
| Ebtehal Gamal Heiba* 1; sonia Gamal ElSharkawy1; Gamal Soliman2; Basma Badreldin Hassan3; Carmen Ali Zarad4 | ||
| 1pediatrics ,faculty of medicine ,port Said university,Port Said Egypt | ||
| 2Pediatrics, Faculty of medicine Port Said University | ||
| 3Clinical pathology ,Faculty of Medicine,Port said university | ||
| 4Associate professor of Diagnostic Radiology, Faculty of Medicine, Port Said University, Egypt | ||
| Abstract | ||
| Background: Early diabetic nephropathy (DN) in children with type 1 diabetes mellitus (T1DM) is often undetectable by conventional screening methods. Renal Doppler ultrasound (RDU), by measuring the renal resistive index (RI), and serum soluble Klotho (s-Klotho), a renal anti-aging protein, may identify subclinical kidney injury before microalbuminuria appears. Objective: To evaluate the diagnostic performance of renal resistive index and serum s-Klotho in detecting early DN in children with T1DM and to explore the correlation between vascular and biochemical changes. Methods: A case–control study was conducted at As-Salam Port Said Hospital including 70 participants: 35 children with T1DM (disease duration ≥ 1 year) and 35 healthy controls. All participants underwent renal Doppler ultrasound to measure interlobar artery RI and laboratory assessment for HbA1c, serum creatinine, creatinine clearance, and s-Klotho (ELISA). Correlations between RI, s-Klotho, and metabolic variables were analyzed using Spearman’s correlation. Results: Children with T1DM had significantly higher mean renal RI (0.69 ± 0.05) compared to controls (0.61 ± 0.04; p < 0.001). Serum s-Klotho levels were significantly lower among diabetic children (1.5 ± 0.9 ng/mL vs 3.5 ± 3.4 ng/mL; p = 0.001). A moderate inverse correlation was found between s-Klotho and RI (ρ = –0.57; p < 0.001). Combining both markers improved diagnostic prediction (AUC = 0.88). Conclusion: Renal resistive index and serum soluble Klotho together provide an effective, non-invasive method for early detection of diabetic nephropathy in children with T1DM, potentially allowing timely intervention before irreversible kidney damage. | ||
| Keywords | ||
| Renal Doppler; Resistive Index; Soluble Klotho; Type 1 Diabetes; Pediatric Nephropathy | ||
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