To evaluate the clinical value of shear wave elastography (SWE) in evaluating the degree of renal damage in patients with type 2 diabetic nephropathy.

A total of 155 diabetic nephropathy patients treated at the Affiliated Hospital of Qingdao University from January 2018 to January 2020 were collected and divided into a normalbuminuria group (55 patients, ACR ＜ 30 mg/g), microalbuminuria group (50 patients, 30 mg/g≤ACR≤300 mg/g), and clinical proteinuria group (50 patients, ACR ＞ 300 mg/g) according to their urinary albumin/creatinine ratio (ACR). Forty-six healthy subjects were selected as a control group. SWE was used to detect the renal parenchymal Young's modulus Emax, Emean, and Emin of the four groups, and serum cystatin C (CysC) of each group was also determined. The changes of Young's modulus and CysC were compared among the four groups, and the correlation between Young's modulus and CysC of each group was analyzed.

Emax, Emean, and Emin were highest in the clinical proteinuria group, followed by the microalbuminuria group, normalbuminuria group, and control group; the differences between groups were statistically significant (P＜0.05). There was no statistically significant difference in CysC levels between the normalbuminuria group and the control group (P=0.124), but there were statistically significant differences between the other two groups and the control group as well as between any two of the normalbuminuria group, microalbuminuria group, and clinical proteinuria group (P＜0.05). There was a positive correlation between Emax, Emean, and Emin and CysC in patients with type 2 diabetic nephropathy (r=0.808, 0.829, and 0.807, respectively, P＜0.05).

SWE can quantitatively evaluate the degree of renal damage in type 2 diabetic nephropathy, and provide a basis for dynamic monitoring of disease progression, evaluation of clinical intervention effect, and adjustment of treatment plan.