الفهرس 
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Abstract
Renal doppler parameters are a useful non-invasive tool to assess renal progression and follow up in CKD patients.
The current study was done to evaluate the usage of ultrasound and ultrasound doppler indices as a non-invasive tool for assessment of GFR decline and rate of progression in patients of CKD.
The children in this study were classified into 2 groups:
group Ι: 30 patients of CKD stage (2-5) under conservative treatment.
group II: 30 of apparently healthy children enrolled as controls of the same age group.
All cases and controls were subjected to complete history taking, thorough clinical examination, laboratory investigations in the form of (complete blood count, Serum creatinine, urea, Na, K, Po4, total calcium, eGFR ) and renal ultrasound and doppler.
Only cases undergone renal biopsy specimen and histopathological analysis.
In comparison between 2 studied groups regarding renal function, MBP, Hb level, calcium, phosphorus, potassium, and doppler parameters (AI, RI, PI and TAV) statistically significant difference was present between the 2 groups. While no significant difference regarding demographic data, weight, height/length, BSA, sodium and mean renal volume.
Regarding the correlation between renal pathology and different doppler parameters, we found that PI significantly correlate with the severity of global sclerosis, tubular atrophy and interstitial fibrosis, while RI significantly correlate with the severity of global sclerosis, tubular atrophy, interstitial fibrosis and arterial sclerosis. Also, TAV significantly correlates with the severity of global sclerosis but Mean renal volume and AI did not significantly correlate with severity of renal pathology.
Regarding correlation between CKD stage and different doppler parameters, we found that the stage of CKD positively correlated with PI and RI but did not significantly correlate with mean renal volume, AI and TAV.
Regarding correlation between doppler parameters and GFR, we found that there was significant negative correlation between eGFR and PI and RI. Also, there was no correlation between eGFR and renal volume.
The study showed that there was a cut off point between cases and controls regarding RI, which was 0.66, also there was a cut off point regarding PI which was 1.23.
We concluded that:
Renal doppler parameters gives more informative data than that from traditional ultrasound especially in early cases of CKD.
Renal doppler indices especially RI and PI can be used in follow up of renal progression in CKD patient as a non-invasive tool.
Summery
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RI >0.66 and PI >1.23 should arise alarm in renal patients.
In patients with single kidney, pelvic kidney, horseshoe kidney and any condition where is renal biopsy is contraindicated; we can use renal doppler parameters especially RI and PI as a non-invasive tool to diagnose and follow up state of CKD.
We can use RI and PI for follow of GFR as a non-invasive tool.
We recommended that:
To use renal doppler indices instead of traditional US for early diagnosis of CKD.
To use renal doppler indices for follow up of GFR and renal progression in CKD patients.
To use renal doppler indices in patients who are contraindicated for renal biopsy for diagnosis and follow up of state of CKD.