ORIGINAL ARTICLE Diagnostic value of quantitative contrast-enhanced ultrasound (CEUS) for early detection of renal hyperperfusion in diabetic kidney disease Ling Wang • Jian Wu • Jia-Fen Cheng • Xin-Ying Liu • Fang Ma • Le-Hang Guo • Jun-Mei Xu • Tianfu Wu • Chandra Mohan • Ai Peng • Hui-Xiong Xu • Ya-Xiang Song Received: 26 November 2014 / Accepted: 9 February 2015 Ó Italian Society of Nephrology 2015 Abstract Purpose To investigate the diagnostic value of quantita- tive contrast-enhanced ultrasound (CEUS) for early detection of renal hyperperfusion in diabetic kidney disease (DKD). Materials and methods 55 DKD patients with estimated glomerular filtration rate (eGFR) [ 30 ml/min/1.73 m 2 and 26 normal controls (NCs) were enrolled. Clinical data was well documented. Blood samples were drawn for evalua- tion of renal function including blood urea nitrogen (BUN), serum creatinine (SCr) and serum uric acid (SUA), and urine samples were assayed for total protein quantification, and various microprotein markers. According to eGFR level, DKD patients were divided into early-stage DKD (eGFR C90 ml/min/1.73 m 2 ,n = 18) and middle-stage DKD (eGFR 30–90 ml/min/1.73 m 2 ,n = 37). Based on urinary microalbumin/creatinine ratio (MALB/UCR), early-stage DKD patients were further classified into two groups: MALB/UCR \ 10 g/mol (n = 11) and MALB/ UCR C10 g/mol (n = 7). Then, CEUS was performed to observe the real-time renal perfusion, and low acoustic power contrast-specific imaging was used for quantitative analysis. Results The renal perfusion images of CEUS were well developed successively. The corresponding perfusion curves based on echo-power signals in time series were constructed. Quantitative analysis showed that area under the descending curve (AUC2) was significantly increased L. Wang, J. Wu and J.-F. Cheng contributed equally to this paper. Electronic supplementary material The online version of this article (doi:10.1007/s40620-015-0183-3) contains supplementary material, which is available to authorized users. L. Wang  J.-F. Cheng  X.-Y. Liu  A. Peng  Y.-X. Song (&) Department of Nephrology and Rheumatology, Shanghai Tenth People’s Hospital, Tongji University, No. 301 Yanchangzhong Road, District of Zhabei, Shanghai 200072, China e-mail: yaxiangs@126.com L. Wang e-mail: nowax@126.com J.-F. Cheng e-mail: 034379@tongji.edu.cn X.-Y. Liu e-mail: singing_l@163.com A. Peng e-mail: pengai@tongji.edu.cn J. Wu  L.-H. Guo  J.-M. Xu  H.-X. Xu (&) Department of Ultrasound in Medicine, Shanghai Tenth People’s Hospital, Tongji University, No. 301 Yanchangzhong Road, District of Zhabei, Shanghai 200072, China e-mail: xuhuixiong@hotmail.com J. Wu e-mail: apagar@126.com L.-H. Guo e-mail: gopp1314@hotmail.com J.-M. Xu e-mail: Junmei_510@hotmail.com F. Ma Department of Ultrasound, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China e-mail: mafang59@126.com T. Wu  C. Mohan Department of Biomedical Engineering, University of Houston, 3605 Cullen Blvd, Houston, TX 77204, USA e-mail: tianfu.wu@gmail.com C. Mohan e-mail: cmohan@central.uh.edu 123 J Nephrol DOI 10.1007/s40620-015-0183-3