 This is Dr. Pagni also here I will be discussing about Crohn's patients with Crohn's kidney. Introduction. Crohn's kidney disease represents an increasing epidemiological burden in current scenario with a global prevalence of 11 to 13 percent. Its detection in current medical practice relays mainly on biological markers irrespective of the underlying etiology. CQD progresses with parantimer fibrosis, tubular intestinal atrophy and sclerosis of the glomerular compartment. These structural abnormalities as detected by conventional grayscale ultrasonic images are not objectively qualifiable. Therefore, a qualifiable non-invasive imaging method is needed. A real-time short duration acoustic push pulse is used to generate shear wave that propagates perpendicular to the main ultrasonic beam. When the waves hit the targeted tissue, the tissue is pushed in the direction of the propagation of the waves, causing it for temporarily to deform or displace. The ultrasound scanner can monitor the tissue displacement measuring the time to make displacement and the recovery type. Shearing velocity increases in decreased tissues, disease tissues, which can be significantly stiffer than normal ones. The parameters are expressed in pressure unit of kilopascals and velocity meter per second. The objectives of the studies are assess elastographic values in patients with chronic kidney diseases to compare the elastography values between the normal participants and patients with chronic kidney diseases. Methodology. All the patients were explained regarding the procedure and written informed consent was taken. Source of data was conducted in the department of radio diagnosis, myso-medical college and research institution. And all the patients including the study underwent conventional abdominal ultrasonography to measure the kidney length, cortical thickness, shear wave elastography to measure the real and parallel stiffness, patient details, creatinine values and EGFR was calculated. The samples size included 60 cases and 60 controls. It was a cross-sectional study conducted from January 2020 to December 2021. And the data obtained from the study were entered in the Microsoft Excel sheets and descriptive statistics such as percentage proportions were used for the preliminary analysis, mean and standard deviation were calculated to meet the objectives and appropriate test of significance such as independent sample data were applied. Data was to be presented in the forms of tables and charts. Inclusion criteria included all the patients of age groups of all age groups referred from department of nephrology, internal medicine, urology, surgery, department and which were referred to our department for the renal elastography with chronic kidney diseases. Controls were the patients with no other comorbidities or other comorbidities subjected for abdominal ultrason for other causes without chronic kidney diseases. Exclusion criteria were the patients with renal cortical thickness less than 10 mm and patients not giving written informed consent and patients not willing for the bloody investigations. After taking written informed consent, all the patients included in the study underwent abdominal ultrasonography using 1 to 5 MHz high-frequency convex transducer C5-1 influence affinity 70 ultrasound machine with shear wave elastography technique. On conventional ultrasound renal length with cortical thickness was measured. For calculating the elastography values, the probe was to be placed on the patient with minimal compression techniques in the lateral ridiculous position and the patient was asked to hold his or her breath for a few seconds in the inspiration. Then the predefined area of interest of the box 10 x 5 mm was placed at the renal cortex of the kidney excluding the renal medulla. The axis of sample box should be kept parallel to the axis of pyramids in medulla and shear wave values were measured in meters per second. Five such readings were taken in each kidney excluding the poles. The same was repeated on the opposite kidney. Blood investigations like creatinine were taken from the hospital records and EGFR was calculated and grading of CKD was done. The values were compared with a control group and analysis to find whether the results were statistically significant or not. The statistical methods applied are as an analytical study which has divided the study population into cases and the control groups mainly based on the presence or absence of the CKD with references of serum creatinine levels and EGFR values. Study population was further categorized depending on the age and sex of the groups and further significance was stepped by the unimerid analysis among these parameters when unparalleled with the respective shear wave velocities and was found to have no statistical significance. And paired sample detest were used to calculate whether mean shear wave elasticity value differences between the right and the left kidney were of significance or not and were found to be not significant. Later, mean shear wave elasticity were compared between the cases and the control using independent sample detests with results providing them to be of statistical significance. The ROC curve was derived to select an optimal cutoff values between cases and the control. Statistical software was used is SPSS 18.0 is used in this case and analysis of the data and the Microsoft world and Excel have been used to generate in the form of graphs and tables. Here is the table of cases and the control groups comparison between the various parameters like kidney length with renal parantimal thickness and the creatinine values along with the EGFR values. Here is the table providing the incidence of predisposing conditions such as diabetes mellitus, hypertension and analgesic abuse in the cases and the control group and was found to be the incidence was found to be more in the case group. And the comparison of the average elasticity values in the case and control group was done in cases the elastography values mean elastography values was 1.474 meters per second in the cases group while in the control 1.316 meters per second and the P value was 0.001 which was found to be statistically significant. And also we have developed an ROC curve for the different stages of the CKD and a ROC of 1.3 was considered. The ROC curve cases versus control here total of 60 number in the case group and 60 in the control group 46 were labeled as positive in the case group considering mean shear wave elastography values of 1.35 meters per second and 18 were positive in the control group while it was in the control group 42 people were termed to be negative with the mean shear wave elastography of less than 1.35 meters per second and 14 were considered to be positive. Characteristics of the test the sensitivity of 76.6% specificity of 70% positive predictive value of 71% and negative predictive value of 75% was there. And the results of the statistical analysis were as follows total of 120 individuals were taken and which were divided as 60 as cases and 60 as controls and in the control group the mean age was 48.1 years and the range of the ages were from 16 to 78 years and of which male and female distribution were equal 30 and the mean age group of the case group was 56.2 years with ages ranging from 33 to 85 years in the case group 45% were found to be female and 55% were found to be male. The mean length of right kidney was 9.62 cm and left kidney was 9.67 cm in the control group and the mean width was 4.31 cm and 4.45 cm respectively in the control group. Mean length of right kidney was 8.8 cm and left kidney was 8.81 cm in case group while mean width of right kidney was 4.03 cm and left kidney was 4.1 cm in case group. Mean parent canal thickness of right and left kidney were 1.37 cm and 1.4 cm respectively in the control group while that of in the case group were 1.27 cm and 1.34 cm. Mean serum creatinine values in case group was 3.67 mg per dl with the range of 0.9 to 12.7 mg per dl Mean serum creatinine values in case group was 0.7 mg per dl with values ranging from 0.49 mg per dl to 0.94 mg per dl corresponding mean EJFR values were 35.55 mg per minute per 1.73 m2 in case group and 102 mg per minute per 1.73 m2 in control group and the incidence of the diabetes meritus, hypertension and allergies were 61.2%, 58.3%, 20% respectively in the case group and that of the control group were 20%, 8.3% and 5% respectively in the control group. Among the case group, average renal parent canal shear wave elasticity values were 1.470 m2 per second in right kidney and 1.478 m2 per second in left kidney and there was no significant statistical association between them. Among the control group, the average renal parent canal shear wave elasticity value was 1.32 m2 per second in right kidney and 1.31 m2 per second in left kidney and there was no significant statistical association formed between them. The mean shear wave elasticity value in control group in various age groups from 1.37 m2 per second in age group of less than 50 years and 1.27 m2 per second in age greater than 50 years where there were found to be more statistical association between the age group. Mean shear wave elasticity values among the male in control group was 1.32 m2 per second and among females it was 1.31 m2 per second with no significant statistical importance. Mean shear wave velocity values among males in case group was 1.47 m2 per second and 1.47 m2 per second among females and there was no significant statistical association while the mean shear wave elasticity values was 1.47 m2 per second in case and 1.316 m2 per second in control group with a standard deviation of 0.1464 and 0.154 respectively and there was found to be statistically significant difference between the mean shear wave elasticity value between the cases in the control group by independent sample test and the p-value being 0.001. Our OC curve for cases in control was used with optimal shear wave elasticity cutoff of 1.35 m2 per second sensitivity being 76.6% specificity 70% while probability predictive value and negative predictive value being 71-75% respectively. Moving on to the discussion, our case is a type of case control study designed to use this novel advancement in the field of radio diagnosis and to determine whether this advancement helps us improve the diagnostic accuracy of diagnosing chronic kidney disease by a non-invasive approach. Cleaner shear wave elastography has the potential to assess the early renal damage hence it is important to assess the normal values of elasticity using shear wave elastography thereby these values can be used as the reference values for assessing the cutoff to detect early renal damages in further studies. Our study showed the shear wave elasticity value between cases and control and tried to determine whether the results were of clinical significance. Cleaner shear wave elasticity values in control groups of varied age group were from 1.35 m2 per second in age group less than 50 years and 1.27 m2 per second in age greater than 50 years. And also among the males and the females there was difference which was not found to be statistically significant in either of the groups. Each of these studies according to their receiver operative works derived the cutoff value to maximize their diagnostic yield with the sensitivity, specificity, positive predictive value and negative predictive value as previously described. The limitation of the studies where the technical difficulty of praising the ROI box in the renal parent primer because it was pretty different and non-adjustable 10 cross 5 mm box and also it had limitation of not including the patients with renal parent primer less than 1 centimeter because of praising the box. And there was also we found there was difference in the shear wave elasticity values with age groups. Our sample group was very small to perform an age derived standardization chart for shear wave elasticity values which could benefit by providing the better characterization as the study was conducted in a similar center with limited catchment area the study results may not be generalized. Here are few of the representative images of the cases and the controls. Moving on to the control one 42 years old male patient with complaints of generalized weakness. The parameters were 0.86 mg per day EGFR 107 ml per minute per 1.73 meter square on grayskill images we have accumulated the data as length of the right kidney 11 centimeter width 5.2 centimeter parenchyma thickness 1.8 centimeter left kidney 11.5 centimeter width 5.6 centimeters parenchyma thickness 1.8 centimeter and we have found that the mean shear wave velocity of the right kidney being 1.25 meters per second and left kidney 1.19 meters per second second control 29 years old female patient with history of fever serum creatinine values 0.82 mg per day EGFR being 99 ml per minute per 1.73 meter square grayskill measurements were as follows right kidney measurements length 10 centimeter width 3.9 centimeter parenchyma thickness 1.3 centimeter left kidney length 9.6 centimeter width 3.7 centimeter parenchyma thickness 1.3 centimeters the average wave velocity of the right kidney is 1.35 meters per second and left was 1.45 seconds meter per seconds moving on to the cases representative image 49 years old male patient with history of diabetes militias since 10 years hypertensives since 7 years and on dialysis since 2 and half years left parameters were serum creatinine 10.9 mg per day EGFR 5 ml per minute per 1.73 meter square CKD stage 5 grayskill measurements right kidney length 7.7 centimeter width 3.4 centimeter parenchyma thickness 1.1 centimeter left kidney length 8 centimeter width 3.8 centimeter parenchyma thickness 1.2 centimeter the mean share wave velocity of the right kidney was 1.47 meters per second and left was found to be 1.39 meters per second second case 48 years old female patient with history of hypertension since 6 years serum creatinine levels were 1.73 mg per day EGFR 34 ml per minute per 1.73 meter square stage 3 CKD right kidney grayskill measurements length 8.9 centimeter width 4.1 centimeter parenchyma thickness 1.2 centimeter left kidney length 8.9 centimeter width 4.2 centimeter parenchyma thickness 1.1 centimeter average heat wave velocity of the right kidney was found to be 1.54 meters per second and left kidney 1.49 meters per second references thank you