Journal of Ultrasound (2018) 21:25–34
Sonographic evaluation of kidney echogenicity and morphology
among HIV sero‑positive adults at Lagos University Teaching Hospital
Cletus Uche Eze
· Charles Ugwoke Eze
· Adekunle Adeyomoye
Received: 31 August 2017 / Accepted: 13 December 2017 / Published online: 5 January 2018
© Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2018
Aim To evaluate the role of kidney echogenicity and morphology in the diagnosis of human immunodeﬁciency virus-
associated nephropathy (HIVAN).
Subjects and methods In the cross-sectional study, a sample of 340 anti-retroviral therapy (ART)-naïve AIDS patients under-
went laboratory CD4+ count, serum creatinine determination and sonographic renal echogenicity grading and size measure-
ment. Rounded kidneys were described as bulbous while bean-shaped kidneys were described as reniform; echogenicity was
categorized into grades 0, 1, 2 and 3. Kidney length, width, thickness and volume were measured in HIVAN and control groups.
Results Mean age of the population was 42.7 ± 9.4 years; 87.4% had HIVAN. Mean CD4+ count, serum creatinine and
GFR for HIVAN patients were 153.1 ± 103.2 cells/mm
, 218.4 ± 147.4 mmol/L and 50.1 ± 23.6 mL/min/1.73 m
and 121.9 ± 91.0 cells/mm
, and 222.0 ± 150.4 mmol/L and 39.3 ± 20.6 mL/min/1.73 m
for females, respectively; control
subjects and non-HIVAN patients had grade 0 renal echogenicity; 56.9% of HIVAN patients had echogenicity grade 3; 5.3%
had kidney length < 10 cm; 73.9% had bulbous kidneys; the kidney was signiﬁcantly wider and thicker in HIVAN (p < 0.05).
Conclusion Sonographic evaluation of renal echogenicity and morphology can reliably predict HIVAN diagnosis. Apathy
to screening and late presentation were high while HIV/AIDS remains an important public health problem in the city of
Lagos. Unilateral reduction in kidney size could be a major sequela of AIDS while sonographic measurement of absolute
kidney length appears inadequate in the evaluation of AIDS patients with nephropathy.
Keywords AIDS/HIVAN · Nephropathy · Echogenicity · Morphology · Sonography
Scopo valutare il ruolo dell’ecogenicità e della morfologia renale nella nefropatia associata a virus dell’immunodeﬁcienza
Pazienti e metodi Questo studio cross-sectional, ha incluso 340 pazienti aﬀetti da AIDS mai trattati con terapia anti-ret-
rovirale (ART). In tutti i pazienti sono state eﬀettuate indagini di laboratorio che comprendevano il conteggio dei linfociti
CD4+ e la determinazione della creatinina sierica, e la valutazione ecograﬁca delle dimensioni e dell’ecogenicità dei reni.
I reni arrotondati sono stati descritti come bozzuti mentre i reni a forma di fagiolo come reniformi; l’ecogenicità è stata
classiﬁcata in gradi 0, 1, 2 e 3. La lunghezza del rene, la larghezza, lo spessore e il volume sono stati misurati in gruppi di
controllo e nei soggetti con HIVAN.
* Cletus Uche Eze
Department of Radiation Biology, Radiotherapy,
Radiodiagnosis and Radiography, Faculty of Clinical
Sciences, College of Medicine, University of Lagos, Ishaga
Road, Idi-araba, Lagos, Nigeria
Department of Medical Radiography and Radiological
Sciences, Faculty of Health Sciences and Technology,
College of Medicine, University of Nigeria, Enugu Campus,