Abstract
To assess the diagnostic performance of different quantitative ultrasound elastography (USE) parameters in differentiating five stages of diabetic kidney disease (DKD) from each other as well as from healthy participants and type 2 diabetic patients without nephropathy. The protocol was pre-registered at https://osf.io/dfu8b/. Using PubMed, Web of Science, Embase, and Cochrane Library, we found studies up to October 10, 2023. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). The USE parameter of cortical stiffness was compared in an inter-stage manner based on mean differences, standardized mean differences, and ratios of means. In addition, cortical stiffness was evaluated for its diagnostic accuracy in staging DKD. Sensitivity and publication bias analyses were also conducted. Certainty of evidence was assessed using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Eighteen studies were included with 2814 participants. The mean stiffness value consistently increased with the progression of the disease. Differentiation of five stages of DKD from two non-DKD groups, respectively, showed sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under curve of 79%, 83%, 4.70, 0.25, 18.68, and 0.88. These values for differentiation of stages 3 to 5 of DKD from the other four milder groups were 80%, 79%, 3.85, 0.25, 15.53, and 0.87, respectively. USE shows promise as a noninvasive, simple, and quantitative diagnostic tool for staging DKD, especially in its early stages. With standardized protocols, its application could benefit patient management by enhancing the accuracy of DKD staging.
Data availability
The data supporting this article can be obtained from the corresponding author upon request.
Abbreviations
- DKD:
-
diabetic kidney disease
- USE:
-
ultrasound elastography
- DM:
-
diabetes mellitus
- SWE:
-
shear wave elastography
- DTA:
-
diagnostic test accuracy
- MD:
-
mean differences
- SMD:
-
standardized mean differences
- AUC:
-
area under curve
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All authors contributed significantly to this article. A.Mohe: statistical analysis, data extraction, data screening. S.M: primary writer of manuscript, data extraction. F.A: providing revision for writing of manuscript. A.Moha: Manager and principal investigator, study design.
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Mohebbi, A., Mohammadzadeh, S., Asli, F. et al. To explore the performance of ultrasound elastography in staging diabetic kidney disease: a systematic review and meta-analysis. Sci Rep (2026). https://doi.org/10.1038/s41598-026-39278-w
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DOI: https://doi.org/10.1038/s41598-026-39278-w
