Year: 2017
Type: article
Study design: Observational Study
Abstract: INTRODUCTION AND AIMS: Renal tissue hypoxia is generally considered as the common final pathway in the development and progression of chronic kidney disease (CKD). BOLD-MRI studies have recently demonstrated that CKD patients have higher cortical R2* values (corresponding to lower oxygenation) than controls. Whether cortical oxygenation as measured with BOLD-MRI predicts renal function decline is unknown. METHODS: Blood-oxygenation level dependent MR imaging was performed under standardized conditions in a cohort of 112 CKD patients, 47 hypertensives and 24 controls. Images were analyzed with the twelve-layer concentric objects method (TLCO) that divides renal parenchyma in 12 layers of equal thickness (see left image), and reports the mean R2* value of each layer, along with the change in R2* between successive layers called the R2* slope (see graph, in pink). Circulating creatinine values were followed over time and estimated glomerular filtration rate (eGFRcreatinine) was used to calculate the yearly change in glomerular function. Participants were classified as “progressors” when their eGFR decline was ≥3.3 ml/min/1.73m²/year. RESULTS: The mean±SD follow up period was 3.0±1.1 years, and 5.3±2.7 creatinine values were available per individual. The eGFR decline was respectively -2.0±6.0, 0.5±4.9 and -0.2±5.3 ml/min/1.73m²/year in CKD, hypertensive patients and controls, and the percentage of progressors 30.2, 18.2 and 16.7%. In multivariable regression analysis adjusted for age, gender, diabetes, RAS blockers, baseline eGFR and proteinuria, the yearly eGFR decline correlated negatively with baseline 24h proteinuria (regression coefficient β±SE: -1.41±0.60, p=0.020) and mean R2* value of the outer (cortical) layers (β -0.41±0.16, p=0.013), but not with the other above mentioned covariates. The R2* slope correlated positively with eGFR decline (β 0.44±0.17, p=0.012). Similar results were found with logistic regression for the association between “progressor” status and cortical R2* (OR and 95% CI per R2*: 1.16 (1.00-1.35), p=0.047). MO005 Figure
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2617711726