Background: Diabetic nephropathy (DN) is a common complication of diabetes mellitus (DM), impacting the kidneys. Ultrasound serves as a valuable tool for evaluating manifestations of metabolic syndrome and nephropathy [1-3]. This study aims to investigate the efficacy of ultrasound (US) as a predictive diagnostic tool for identifying specific variants of nephropathy in patients with DM. Methods: Thirty individuals with diabetes (age 38-76, 18 females) requiring medication for glucose control were compared with 30 age-matched controls (equal gender distribution). All participants underwent general clinical and laboratory tests. Abdominal US with convex 2-10 MHz probes was performed, including multiparameter US of the kidneys, utilizing Doppler, shear wave elastography (SWE), and measurement of fat accumulations, including visceral fat (VF) and subcutaneous fat (SF) thickness and areas [1]. Results: The resistive index (RI) in segmental renal arteries exhibited a significant increase (PP<0.05). Conclusion: Multiparameter ultrasound is effective in detecting and distinguishing kidney disease patterns in DM. It provides valuable information for differentiation, modifying treatment approaches, and targeted prevention. The study underscores the significance of US in assessing diabetic nephropathy, offering additional insights into its manifestations. References: 1. Bubnov R, Kalika L, Spivak M. Ultrasound evaluation of visceral fat and posture: relevance for diagnosing metabolic syndrome and obesity. Ultrasound in Medicine and Biology, 2019, 45: S83-S84. DOI: 10.1016/j.ultrasmedbio.2019. 07.283 2. Bubnov R. Shear wave elastography effective in ultrasound diagnosis of chronic kidney disease in patients with hyperuricaemia and gout. Nephrol Dial Transplant. 2022; 37(Supplement_3):gfac096.004. DOI: 10.1093/ndt/gfac096. 004 3. Bubnov R. Ultrasound imaging patterns of kidney disease in patients with metabolic syndrome. Nephrol Dial Transplant, 2023; 38(Supplement_1):gfad 063c_4869. DOI: 10.1093/ndt/gfad063c_4869