Abstract

Background: Prolonged hypertension can induce changes in renal size hence, early detection of these renal changes by ultrasonography may aid early intervention, thereby preventing or minimizing renal damage. This study aimed to sonographically assess kidney parameters in adults with hypertension and compare them with age and sex matched normotensive controls.


Materials and Methods: This was a cross-sectional comparative study involving 330 individuals comprising 165 hypertensives and 165 controls, conducted at the Radiology unit of Delta State University Teaching Hospital (DELSUTH), Oghara, Delta State, Nigeria. Measurements were obtained using an electronic caliper on a DC-30 Mindray ultrasound. Renal cortical echogenicity was assessed by comparison with the echogenicity of the liver and spleen respectively, and graded into four categories: Grade 0 - Normal, Grade 1 - mild, Grade 2 - moderate and Grade 3 – severe. Data were analyzed using IBM SPSS version 22. Statistical tests were considered significant with p< 0.05 at 95% confidence interval.


Results: Hypertensives had greater mean weight, BMI, blood pressure, and serum creatinine but lower eGFR compared to controls (p<0.05). The mean right renal length (9.60±0.50 cm) and left renal length (10.19±0.53 cm) in hypertensives were lower than those measured in controls for the right kidney (9.79±0.63 cm) as well as the left (10.43 ± 0.63 cm), with these differences being statistically significant (p<0.05). This was also recorded for the kidney width, volume and cortical thickness. In the hypertensive group, eGFR exhibited statistically significant positive relationships with right and left renal cortical thickness, renal volume, and renal length, while serum creatinine showed weak negative associations with bilateral cortical thickness. For both kidneys, renal echogenicity varied significantly between cases and controls.


Conclusion: This study showed significantly lower renal volume and cortical thickness among hypertensives compared to controls. Routine imaging assessment in conjunction with sensitive biomarkers may aid the early detection of hypertension and improve clinical management