Correlation of Increased Renal Parenchymal Echogenicity with Renal Function Tests and Urine Routine Examination in Patients from all over Lahore with low Socio-Economic status

Increased Renal Parenchymal Echogenicity with RFTs and Urine R/E in patients


  • Mussarat Ahmed Life Hospital, Lahore
  • Aliza Gulzar Bukhari Life Hospital, Lahore



Urinary Tract Infection (UTI); Renal Function Tests (RFTs); Renal Parenchymal Echogenicity; Urine Routine Examination (Urine R/E); Dehydration; Chronic Kidney Disease (CKD).


To evaluate the cause of increased renal parenchymal echogenicity in patients coming in our hospital set-up. Materials and Methods: A descriptive study was conducted at Life Hospital, Lahore over a period of fourteen months. A total of 115 patients both male and female, aged 12 to 83 years with the diagnosis of increased renal parenchymal echogenicity were included in the study and patients with normal renal cortical echogenicity were excluded from this study. The study includes different grades of renal parenchymal echogenicity, both males and females of different age groups and correlation with lab findings (Renal Function Tests and Urine R/E). Statistical analysis was conducted in SPSS version 22.0 and Microsoft Excel. Results: Renal parenchymal echogenicity was raised in 55% of males and 44% of females. The most common cause for increased renal parenchymal echogenicity was concluded to be Urinary Tract Infection (UTI)%; (with WBCs seen in 28% of patients, Blood seen in 25% of patients, Leukocytes seen in 23% of patients, RBCs seen in 22% of patients and pus cells seen in 3% of patients). Only 8% of patients were seen with deranged RFTs. Mean age of patients with increased renal parenchymal echogenicity was 32.4 years. Most patients presented with lumbar region pain, burning micturition and dehydration. Conclusion: UTI seems to be the main cause of increased renal parenchymal echogenicity in the patients we studied as majority of the patients did not have a normal urine report. Males were more likely seen with increased renal parenchymal echogenicity. As majority of our patients belonged to poor socio-economic status, so it was concluded that the main cause of UTI could be dehydration due to lack of availability of clean water and poor hygiene conditions.


Soriano RM, Penfold D, Leslie SW. Anatomy, Abdomen and Pelvis, Kidneys. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2021.

Lee JH, Cho MH, Chung SI, Lim SD, Kim KS. Relationship of renal echogenicity with renal pathology and function. Childhood Kidney Diseases. 2017,21(2):47-52.

Gounden V, Bhatt H, Jialal I. Renal Function Tests. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2021. Renal parenchymal disease | Texas Children's Hospital.2022

Ahmed S, Bughio S, Hassan M, Lal S, Ali M. Role of ultrasound in the diagnosis of chronic kidney disease and its correlation with serum creatinine level. Cureus. 2019,11(3).

Quaia E, Correas JM, Mehta M, Murchison JT, Gennari AG, et al. Gray scale ultrasound, color Doppler ultrasound, and contrast-enhanced ultrasound in renal parenchymal diseases. Ultrasound Quarterly. 2018,34(4):250-67.

Preston RA, Epstein M. Renal parenchymal disease and hypertension. seminars in Nephrology 1995, (Vol. 15, No. 2, pp. 138-151).

Dahiya, N. Ultrasound: The Requisites: Third Edition Barbara S. and Hertzberg William D. Middleton. Abdom Radiol 41, 205,

Araújo NC, Rebelo MA, da Silveira Rioja L, Suassuna JH. Sonographically determined kidney measurements are better able to predict histological changes and a low CKD-EPI eGFR when weighted towards cortical echogenicity. BMC nephrology. 2020,21(1):1-8

Platt JF, Rubin JM, Bowerman RA, Marn CS. The inability to detect kidney disease on the basis of echogenicity. American Journal of Roentgenology. 1988,151(2):317- 9.

Manley JA, O'Neill WC. How echogenic is echogenic? Quantitative acoustics of the renal cortex. American journal of kidney diseases. 2001,37(4):706-11.

Peerboccus M, Damry N, Pather S, Devriendt A, Avni F. The impact of hydration on renal measurements and on cortical echogenicity in children. Pediatric radiology. 2013,43(12):1557-65.

Chien CC, Chou YH, Tiu CM, Lin CC, Yang WC, et al. Transient hyperechoic renal cortex caused by dehydration and induced acute renal failure in two patients with intra-abdominal infection. Journal of Medical Ultrasound. 2012,20(1):43-6. What is Renal Parenchymal Disease? Causes, Symptoms, Treatments | Nicklaus Children's Hospital. 2022

Faubel S, Patel NU, Lockhart ME, Cadnapaphornchai MA. Renal relevant radiology: use of ultrasonography in patients with AKI. Clinical Journal of the American Society of Nephrology. 2014,9(2):382-94.

Siddappa JK, Singla S, Mohammed Al Ameen SC, Kumar N. Correlation of ultrasonographic parameters with serum creatinine in chronic kidney disease. Journal of clinical imaging science. 2013,

Libório AB, de Oliveira Neves FM, de Melo CB, Leite TT, de Almeida Leitão R. Quantitative renal echogenicity as a tool for diagnosis of advanced chronic kidney disease in patients with glomerulopathies and no liver disease. Kidney and Blood Pressure Research. 2017,42(4):

Singh A, Gupta K, Chander R, Vira M. Sonographic grading of renal cortical echogenicity and raised serum creatinine in patients with chronic kidney disease. Journal of evolution of medical and dental sciences. 2016,5(38):

Wiersma F, Toorenvliet BR, Ruige M, Holscher HC. Increased echogenicity of renal cortex: a transient feature in acutely ill children. Ultrasonographic features in children presenting with abdominal pain: normal versus abnormal. 2008:39.

Lee YS, Lee MJ, Kim MJ, Im YJ, Kim SW, et al. Is increased echogenicity related to a decrease in glomerular filtration rate? Objective measurements in pediatric solitary.




How to Cite

Ahmed, M. ., & Bukhari, A. G. . (2022). Correlation of Increased Renal Parenchymal Echogenicity with Renal Function Tests and Urine Routine Examination in Patients from all over Lahore with low Socio-Economic status: Increased Renal Parenchymal Echogenicity with RFTs and Urine R/E in patients. Pakistan BioMedical Journal, 5(4), 119–122.



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