Color-Doppler sonographic tissue perfusion measurements reveal significantly diminished renal cortical perfusion in kidneys with vesicoureteral reflux

Abstract

Vesicoureteral reflux (VUR) and its sequelae may lead to reduced renal perfusion and loss of renal function. Methods to describe and monitor tissue perfusion are needed. We investigated dynamic tissue perfusion measurement (DTPM) with the PixelFlux-software to measure microvascular changes in the renal cortex in 35 children with VUR and 28 healthy children. DTPM of defined horizontal slices of the renal cortex was carried out. A kidney was assigned to the “low grade reflux”-group if the reflux grade of the voiding cystourethrogram was 1 to 3 and to the “high grade reflux”-group if the reflux grade was 4 to 5. Kidneys with VUR showed a significantly reduced cortical perfusion. Compared to healthy kidneys, this decline reached in low and high grade refluxes within the proximal 50% of the cortex: 3% and 12 %, in the distal 50% of the cortex: 21% and 44 % and in the most distal 20 % of the cortex 41% and 44%. DTPM reveals a perfusion loss in kidneys depending on the degree of VUR, which is most pronounced in the peripheral cortex. Thus, DTPM offers the tool to evaluate microvascular perfusion, to help planning treatment decisions in children with VUR.

Effect of Respiratory Failure on Peripheral and Organ Perfusion Markers in Severe COVID-19: A Prospective Cohort Study

“…Our results show a significant association between the severity of respiratory failure and the impairment of peripheral and organ perfusion, which seems to be consistent with the pathophysiology of the development of ARDS. The usefulness of DTPM developed by Scholbach was investigated in many clinical applications [39][40][41]43,44]. Lubas et al proved its usefulness in the assessment of renal perfusion among patients with hypertension and glomerulonephritis.…”

“…Renal cortical perfusion (RCP) estimated by DTPM is quantified by the volume of blood flowing through the studied area (ROI-region of interest) over a specified period of time, which is equivalent to organ perfusion [40]. This non-invasive and readily available test proved its efficacy [41,42] in various clinical scenarios [43][44][45][46].…”