Multiparametric ultrasound in the evaluation of kidney disease in elderly

  • Francesco Maria DrudiEmail author
  • Vito Cantisani
  • Antonio Granata
  • Flavia Angelini
  • Daniela Messineo
  • Carlo De Felice
  • Evaristo Ettorre
Review Paper


After the age of 30 years, GFR progressively declines at an average rate of 8 mL/min/1.73 m/decade. A problem of advanced age is that the evaluation of renal function on the basis of indicators valid in young adults, such as creatininemia, is unreliable. In fact, many patients with chronic renal failure may have serum creatinine levels within the normal range even if they have a significant reduction in renal function. Ultrasound has become a routine method of investigation in renal disease: kidney size and parenchymal echogenicity are considered markers of renal function, so US is useful in assessing the presence and degree of renal failure. CEUS is useful in the evaluation of kidney disease in the elderly: the increased hemodynamic resistance of renal microvessels reduces perfusion in the renal cortex, so fewer microbubbles enter the renal cortex. EcoColor and EcoDoppler are also useful in the evaluation of senile alterations: here, the distribution of color-signals, as compared to that in the young adult population, appears more attenuated, limited to intersegmental and interlobar districts. Among the ecoDoppler parameters, the resistance index can be considered a marker of renal damage progression, with attention needing to paid to possible concomitant confounding factors. Ultrasonography, color-Doppler and CEUS are a non-invasive and convenient modality for managing kidney disease; their integration with anamnestic, objective and laboratory data permits fast and reliable clinical, diagnostic, and therapeutic classification. It also allows early therapeutic intervention and, ultimately, improvements in patient management.


Multiparametric ultrasound Chronic kidney disease Contrast-enhanced ultrasound Color Doppler Kidney transplantation 


Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2019

Authors and Affiliations

  • Francesco Maria Drudi
    • 1
    Email author
  • Vito Cantisani
    • 1
  • Antonio Granata
    • 3
  • Flavia Angelini
    • 1
  • Daniela Messineo
    • 1
  • Carlo De Felice
    • 1
  • Evaristo Ettorre
    • 2
  1. 1.Department of Radiological, Oncological and Path. SciencesSapienza University of RomeRomeItaly
  2. 2.Department of Cardiovascular, Respiratory, Nephrological, Anaesthetic and Geriatric SciencesSapienza University of RomeRomeItaly
  3. 3.Department of Nephrology and DyalisisSan Giovanni di Dio HospitalAgrigentoItaly

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