<b>Association of Computed Tomography Findings with Severity of Chronic Kidney Disease</b>

Background: Chronic kidney disease is a progressive disorder characterized by structural and functional renal impairment, and early imaging markers that reflect disease severity remain clinically important. Objective: To assess the association of computed tomography-derived renal morphometric parameters, cortical thickness, and cortical density with the severity of chronic kidney disease. Methods: A cross-sectional observational study was conducted on 100 patients with chronic kidney disease who underwent plain and contrast-enhanced renal CT between June 2023 and August 2024. Renal length, width, volume, cortical thickness, and cortical density were measured and compared across CKD stages using the Kruskal-Wallis test with post hoc analysis where appropriate. Results: The study included 54 males and 46 females, with a mean age of 45.88 ± 11.03 years and mean BMI of 22.74 ± 2.58 kg/m². Significant differences were observed across CKD stages for kidney length (p = 0.000001), kidney width (p = 0.003401), kidney volume (p < 0.000001), and cortical density (p < 0.000001). Median kidney length declined from 13.80 in Stage I to 7.40 in Stage III, while median kidney volume decreased from 95.00 to 50.50 over the same comparison. Cortical density increased markedly from 410.00 in Stage I to 1626.75 in Stage V. Cortical thickness did not differ significantly across stages (p = 0.335104). Conclusion: CT-derived renal morphometric measures and particularly cortical density were significantly associated with CKD severity, whereas cortical thickness was not. These findings suggest that quantitative CT parameters may assist in structural staging of CKD, although further validation with standardized protocols is required.