Reduced oxygenation but not fibrosis defined by functional magnetic resonance imaging predicts the long-term progression of chronic kidney disease. Issue 6 (12th November 2018)

• Record Type: Journal Article
• Authors: Sugiyama, Kei; Inoue, Tsutomu; Kozawa, Eito; Ishikawa, Masahiro; Shimada, Akira; Kobayashi, Naoki; Tanaka, Junji; Okada, Hirokazu
• Is Part Of: Nephrology dialysis transplantation. Volume 35:Issue 6(2020)
• Page Start: 964
• Page End: 970
• Publication Date: 2018-11-12
• Subjects: blood oxygen level–dependent magnetic resonance imaging -- diffusion-weighted magnetic resonance imaging -- fibrosis -- glomerular filtration rate -- hypoxia; Nephrology -- Periodicals; Hemodialysis -- Periodicals; Kidneys -- Transplantation -- Periodicals; Hemodialysis; Kidneys -- Transplantation; Nephrology; Periodicals; 616.61
• DOI: 10.1093/ndt/gfy324
• Languages: English
• ISSNs: 0931-0509

Abstract

Abstract: Background: Although chronic hypoxia and fibrosis may be a key to the progression of chronic kidney disease (CKD), a noninvasive means of measuring these variables is not yet available. Here, using blood oxygen level–dependent (BOLD) and diffusion-weighted (DW) magnetic resonance imaging (MRI), we assessed changes in renal tissue oxygenation and fibrosis, respectively, and evaluated their correlation with prognosis for renal function. Methods: The study was conducted under a single-center, longitudinal, retrospective observational design. We examined the prognostic significance of T2* values of BOLD-MRI and apparent diffusion coefficient (ADC) values on DW-MRI and other clinical parameters. The rate of decline in estimated glomerular filtration rate (eGFR) was calculated by linear regression analysis using changes in eGFR during the observation period. Results: A total of 91 patients were enrolled, with a mean age of 55.8 ± 15.6 years. Among patients, 51 (56.0%) were males and 38 (41.8%) had diabetes mellitus. The mean eGFR was 49.2 ± 28.9 mL/min/1.73 m 2 and the mean observation period was 5.13 years. ADC values of DW-MRI but not T2* values of BOLD-MRI were well correlated with eGFR at the initial time point. The mean annual rate of decline in eGFR during the 5-year observation period was −1.92 ± 3.00 mL/min/1.73 m 2 . On multiple linear regression analysis, the rate of decline in eGFR was significantly correlated with eGFR at the start point, period average amount of proteinuria and T2* values, but not with ADC values ( t = 2.980, P = 0.004). Conclusions: Reduced oxygenation as determined by low T2* values on BOLD-MRI is a clinically useful marker of CKD progression.