Araújo NC, et al. - This study explored the accuracy of crude and composite ultrasound parameters based on kidney measurements and cortical echogenicity to diagnose renal dysfunction and histological alterations. Researchers conducted kidney sonography and biopsy in 112 individuals. They obtained kidney length, the kidney length/body height ratio (KL/H) and cortical thickness. A cortical echogenicity-weighting arbitrary factor multiplied each parameter: 1.17, 1 or 0.69 for cortex less than, equal to or higher than the liver, respectively. The chronic kidney disease epidemiology collaboration(CKD-EPI) formula was applied to calculate glomerular filtration rate (GFR). They examined the accuracy of crude and composite parameters to distinguish individuals with a high creatinine, a low GFR and histological alterations. The data indicate that in CKD, w-KL/H exceeded the other parameters as a marker of renal impairment and histological alterations. Estimation of the w-KL/H index may be of assist as a non-invasive tool to distinguish individuals with significant renal disease and might be beneficial to support therapeutic decisions.