Background/Objectives: This study evaluated the applicability of B-mode ultrasound, Doppler, and elastography in the early diagnosis of non-azotemic acute kidney injury (AKI) in rats induced with cyclophosphamide. Methods: The prospective, randomized, and blinded experiment involved groups receiving cyclophosphamide (CG, n = 12) and saline (control, SG, n = 9). Serum biomarkers (urea, creatinine, and symmetric dimethylarginine) were assessed, along with renal histological analysis to classify AKI severity and distribution. Results: B-mode ultrasound revealed a significantly higher corticomedullary ratio at 24 and 72 h and increased renal width at 48 h in the cyclophosphamide group compared to controls. Biochemical analyses showed no significant differences between groups in early stages. Although B-mode ultrasound detected early morphological changes—specifically in corticomedullary ratio and renal size—Doppler and elastography demonstrated limited diagnostic utility in early AKI detection. Conclusions: Overall, B-mode ultrasound provided valuable early indicators of renal injury, whereas Doppler and elastography showed minimal clinical benefit at this stage.
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