Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website https://www.jocmr.org

Original Article

Volume 14, Number 2, February 2022, pages 95-105

Shear Wave Elastography in the Evaluation of Renal Parenchymal Stiffness in Patients With Chronic Kidney Disease: A Meta-Analysis

Figures

Figure 1.
Figure 1. Relationship or mechanisms between renal parenchyma stiffness, fibrosis, impaired renal function, and mortality. CKD: chronic kidney disease; GFR: glomerular filtration rate.
Figure 2.
Figure 2. Screening processes of document and results.
Figure 3.
Figure 3. Quality assessment of the studies according to QUADAS-2. QUADAS: Quality Assessment of Diagnostic Accuracy Studies.
Figure 4.
Figure 4. The Forest plots showing diagnostic performance estimates (sensitivity and specificity) of CKD fibrosis. CKD: chronic kidney disease; CI: confidence interval.
Figure 5.
Figure 5. The Forest plots demonstrating the study specificity of SWE on the right y axis in the evaluation of CKD fibrosis. CKD: chronic kidney disease; SWE: shear wave elastography; CI: confidence interval; DLR: digital light radiography.
Figure 6.
Figure 6. The Forest map plot designed to demonstrate study-specific CKD of SWE on the right y axis in assessment. CKD: chronic kidney disease; SWE: shear wave elastography; CI: confidence interval.
Figure 7.
Figure 7. The SROC curve: midas tp fp fn tn, es (x) plot SROC2 graph. SROC: summary receiver operating characteristic curve; LR: likelihood ratio.
Figure 8.
Figure 8. The Fagan’s nomogram for SWE illustrating post-test probability with a fixed pre-test probability of 20% for CKD. CKD: chronic kidney disease; SWE: shear wave elastography; SEN: sensitivity; SPE: specificity.
Figure 9.
Figure 9. The Deeks funnel plot is a bias-odd detection of the published results, all distributed on both sides of the regression lines, indicating that no significant deviations were found.

Tables

Table 1. Characteristics and Diagnostic Performance of Included Studies of CKD Fibrosis
 
Studies includedCountryAveraged age (range)Sample sizeEtiologySensitivitySpecificity
CKD: chronic kidney disease.
Leong et al, 2018 [18]Malaysia55106Chronic kidney disease0.8030.795
Radulescu et al, 2018 [19]Romania62.875 (48 - 79)32Chronic kidney disease0.8750.65
Samir et al, 2015 [20]America61 (56 - 70)25Chronic kidney disease0.800.75
Yang et al, 2020 [21]China46.9 (23.0 - 68.0)120INS disease0.8170.933
Turgutalp et al, 2020 [22]Turkey40.2 ± 11.330IgAN disease0.8900.900
Grosu et al, 2021 [23]Romania57.5 ± 13.492Chronic kidney disease0.8920.769

 

Table 2. The Diagnostic Threshold (kPa) of SWE in Fibrosis With Chronic Kidney Disease
 
EtiologySWEStudies included
SWE: shear wave elastography; INS: idiopathic nephrotic syndrome; IgAN: immunoglobulin A nephropathy; SWV: shear wave velocity; kPa: kilopascals.
Chronic kidney diseaseYM = 4.31 kPaLeong et al, 2018 [18]
Chronic kidney diseaseYM = 22.95 kPaRadulescu et al, 2018 [19]
Chronic kidney diseaseYM = 5.3 kPaSamir et al, 2015 [20]
INS diseaseYM = 7.96kPaYang et al, 2020 [21]
IgAN diseaseYM > 15 kPaTurgutalp et al, 2020 [22]
Chronic kidney diseaseSWV < 1.47 m/sGrosu et al, 2021 [23]