Abstract: Objective To investigate the diagnostic value of 2D shear wave elastography (2D-SWE) in chronic kidney disease (CKD) and its influencing factors. Methods Renal shearwavevelocity (SWV), pixel intensity and interlobar artery resistance index (RI) were measured in 114 CKD patients and 31 healthy subjects.CKD patients were divided into stage 1 to 5 groups according to K/DOQI grading standard. The differences of three ultrasonic parameters in different groups of CKD were analyzed and compared with those in healthy subjects.The ROC curve was drawn to compare the performance of each technique in the diagnosis of CKD.Results The SWV of CKD patients were lower than that of healthy subjects, and the pixel intensity and RI of renal interlobar artery were higher than those of healthy subjects (all P<0.05), and SWV decreased gradually with the increase of CKD stage, while pixel intensity and interlobar RI increased continuously.The differences of the three parameters among different groups were statistically significant (all P <0.001).In the diagnosis of patients with early CKD, 2D-SWE was significant (P<0.001). The diagnostic sensitivity of left cortical SWV was up to 81.8% when it was less than 1.13m/s, and the specificity of right cortical SWV was up to 90.0% when it was less than 1.16m/s.Moreover, the AUC area of 2D-SWE was larger than that of pixel intensity and interlobar artery RI (both P <0.05), and there was no diagnostic difference between interlobar artery RI and pixel intensity (P>0.05).In the diagnosis of patients with advanced CKD, 2D-SWE, pixel intensity and interlobar artery RI were all of diagnostic significance (all P <0.001), and the curve area of 2D-SWE and pixel intensity was greater than that of interlobar artery RI (all P <0.05), but there was no diagnostic difference between 2D-SWE and pixel intensity (all P >0.05). Stepwise regression analysis showed that systolic blood pressure, RI, pixel intensity and β2 microglobulin were the influencing factors of SWV decrease.Conclusions 2D-SWE, ultrasound histogram and interlobular artery RI have certain diagnostic value for CKD, but 2D-SWE is superior to ultrasound histogram and interlobular artery RI in the diagnosis of early CKD patients. It may be an early diagnosis of CKD, Dynamic monitoring of disease progression, evaluation of curative effect and prognosis provide new methods.