Evaluation of renal parenchymal stiffness using shear wave elastography in Behçet’s disease without clinical renal involvement

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Renal involvement in Behçet’s disease is uncommon but clinically relevant and may remain subclinical in the absence of abnormal renal function tests or urinalysis findings. Shear wave elastography (SWE) may provide quantitative information on renal parenchymal stiffness beyond conventional ultrasonographic parameters. To evaluate renal parenchymal stiffness using SWE in patients with Behçet’s disease without clinical, biochemical, or urinalysis evidence of renal involvement. This prospective case-control study included 29 patients with Behçet’s disease and 40 healthy controls. All participants underwent conventional renal ultrasonography and renal SWE using a standardized protocol. Renal length, width, cortical thickness, and right and left renal parenchymal stiffness values were recorded. Clinical characteristics, laboratory parameters, disease activity scores, organ involvement, and treatment status were analyzed in the Behçet’s disease group. Patients with Behçet’s disease had significantly higher right, left, and mean renal parenchymal stiffness values than healthy controls. Mean renal stiffness was 6.87 ± 1.39 kPa in the Behçet’s disease group and 4.87 ± 0.39 kPa in controls ( p < 0.001). In contrast, renal length, width, and cortical thickness did not differ significantly between groups. Mean renal stiffness showed a positive correlation with erythrocyte sedimentation rate ( r = 0.675, p < 0.001). In multivariable linear regression analysis, erythrocyte sedimentation rate remained independently associated with mean renal stiffness, while composite immunosuppressive treatment was associated with lower stiffness values. Exploratory ROC analysis showed good discriminatory performance of mean renal stiffness for differentiating patients with Behçet’s disease from controls. Renal parenchymal stiffness is increased in patients with Behçet’s disease despite normal renal function, normal urinalysis, and preserved conventional ultrasonographic parameters. As a pilot study, these findings suggest that SWE may provide additional quantitative information on subclinical renal parenchymal alterations in Behçet’s disease; however, larger longitudinal studies are required to validate its clinical significance.

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