Beyond glycemia: renal resistive index provides robust discrimination and incremental clinical utility for proteinuria in type 2 diabetes

Abstract Background Diabetic kidney disease (DKD) is a major complication of type 2 diabetes mellitus (T2DM), with proteinuria being a primary clinical marker. This study explores the renal resistive index (RA_RI), measured by Doppler ultrasound, as a non-invasive vascular biomarker for detecting and classifying proteinuria severity in T2DM patients. Methods A cross-sectional study was conducted on 100 patients with T2DM, equally divided into proteinuric and non-proteinuric groups. Clinical, biochemical, and Doppler ultrasonographic data were analyzed. Diagnostic performance of RA_RI was assessed using ROC analysis, regression models, and decision-curve analysis. Results RA_RI was significantly higher in proteinuric individuals (0.65 ± 0.03) compared to non-proteinuric individuals (0.58 ± 0.01, p