In Prevalence of grade 1 was in

In 2016, Singh A and his colleagues worked on the Sonographic grading of renal cortical echogenicity and raised serum creatinine in patients with chronic kidney disease. He examined 100 patients that have chronic kidney disease with glomerular filtration rate less than 60/mL/min. He include patients of age above 18 years and study was conducted from August 2013 to October 2015. He excluded patients with renal tumor, hepatitis patients and patients on peritoneal dialysis and hemodialysis. The examination was done on the patient’s supine position. The frequency of chronic kidney disease was 32% in diabetic patients. In all the chronic kidney disease patients, echogenicity of renal cortex was increased. Renal length, cortical and parenchymal thickness were measured and its mean value were calculated. The prevalence of Grade 1 was found in 35 patients, Grade 2 in 42 patients had grade 2, Grade 3 were in 16 cases and 7 patients had Grade 4.
2. Worked on ultrasonic grading and correlate the echogenicity of kidneys with serum creatinine level. He diagnosed 60 patients above thirty years with chronic kidney disease according to the guidelines of the National Kidney Foundation 1. He excluded fatty liver patients and patients on hemodialysis. Prevalence of grade 1 was in 48.3% patients, 35% patients had Grade 2 chronic kidney disease, 7(11.7%) had Grade 3 was in 11.7% CKD patients, and 5% had Grade 4.this study showed that ultrasonic grading and Renal echogenicity had better correlation with serum creatinine.
3. In 2006, a strong relationship between chronic kidney disease and obesity was noted. Obesity is a major cause of chronic kidney diseases. Prevalence of CKD also changes as body mass index changes.
4. Josef Coresh and his co-authors check the incidence of CKD in the United States. A cross sectional study was done in non-institutionalized 20 year old adults. The study was done in a period of 1988-1994 and 1999-2004. In 1999 to 2004 the incidence of chronic kidney disease was higher than in 1988 to 1994. This study showed the increase incidence of chronic kidney disease in hypertensive and diabetic.
5. In 2013, increased prevalence of renal stone was noted in type two diabetes mellitus patients.

Material and method
Study area and sample size
I will conduct the cross sectional study in the radiology department of Allied hospital Faisalabad. The study will be conducted on 80 kidney disease patients.
Inclusive Criteria: For the assessment of chronic kidney disease I will include the diabetic patients age group of 25-60 year.
Exclusive Criteria:
In this study I will exclude
• Obese patients
• Hepatitis patients
• Smokers
• Patients with other diseases will be excluded from the study.
• Children
Ultrasound is a safe modality that is used for the diagnosis of variety of diseases. For the diagnosis and grading of chronic kidney disease ultrasound machine with 3.5-5 MHz curvilinear probe will be used. Transverse, oblique and longitudinal views are taken.

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Patient preparation
Patient will be asked to drink a minimum of 24 ounces of clear fluid at least one hour before scan. Generally, no prior preparation, such as fasting or sedation, is required. Asked patient to sign a Consent form that will give permission to do the procedure.
Examination technique
Patient will be asked to lie in the supine position. Ultrasound gel will be placed on the scanned area of the body. Longitudinal and oblique views will be required for the examination of kidneys. The patient will be asked to turn on your side to get a better view of your kidneys. The whole procedure will be done during normal respiration. Renal size and echogenicity will be measured. 10 Doppler ultrasound of the kidney is extensively used for blood vessels examination. For analyzing the data software will be SPSS. Calculate the values and p value will be significant for consideration.