Evaluation of Renal Oxygenation and Hemodynamics in Patients with Chronic Kidney Disease by Blood Oxygenation Level-dependent Magnetic Resonance Imaging and Intrarenal Doppler Ultrasonography

Yang, Jing; Yang, Shouguo; Xu, Yizeng; Lu, Fang; You, Liangzhi; He, Zheng; Zhan, Songhua; Ye, Chaoyang; Liu, Mengxiao; Fu, Caixia; Wang, Chen

doi:10.1159/000516637

Cited by 11 publications

(18 citation statements)

References 30 publications

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“… 15 , 40 A clinical study showed that after dapagliflozin treatment in DN patients, the serum TNF-α level decreased significantly, while eGFR values increased significantly when compared with the levels before treatment. 39 Our study confirmed that the decrease in the CrCl value and the increase in proteinuria during the DN stage were associated not only with high levels of TNF-α and IL-1β in the serum but also with significantly higher expression of TNF-α and IL-1β in the kidney. Additionally, the impairment of renal vascular endothelial function was confirmed by the decreased CrCl value according to some clinical research.…”

Section: Discussionsupporting

confidence: 83%

“…The eGFR value is calculated based on the SCr and UCr values of patients and their clinical age and sex. 39 In animal models, CrCl has been used extensively and is normally calculated with SCr and UCr values, urine volume and BW. 15 , 40 A clinical study showed that after dapagliflozin treatment in DN patients, the serum TNF-α level decreased significantly, while eGFR values increased significantly when compared with the levels before treatment.…”

Section: Discussionmentioning

confidence: 99%

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TNF-α and IL-1β Promote Renal Podocyte Injury in T2DM Rats by Decreasing Glomerular VEGF/eNOS Expression Levels and Altering Hemodynamic Parameters

Wang¹,

Feng²,

Zhang³

et al. 2022

JIR

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Purpose Diabetic nephropathy (DN) is a serious microvascular complication in those with type 2 diabetes mellitus (T2DM). Evidence confirms that serum tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in the T2DM stage are proposed as prognostic markers for DN development, but it is unclear how they affect renal podocyte-associated nephrin and WT-1 expression. In the presence of podocyte injury, glomerular vascular endothelial growth factor (VEGF), endothelial nitric oxide synthase (eNOS) and hemodynamic parameters are dysregulated. The current research aimed to clarify the relationship of TNF-α and IL-1β with podocyte injury by altering VEGF/eNOS expression and hemodynamic parameters. Methods A high-fat diet/streptozotocin-induced DN rat model was established. Serum TNF-α and IL-1β levels were tracked in the pre-T2DM, T2DM and DN stages. In the DN stage, the mRNA and protein expression levels of renal TNF-α, IL-1β, VEGF, eNOS, nephrin and WT-1 were studied. Renal hemodynamic parameters, including peak systolic velocity, end-diastolic flow velocity and mean velocity were measured with a color Doppler ultrasound technique. Results Compared to those in the normal control (CTL) group, serum TNF-α and IL-1β levels increased significantly in the pre-T2DM stage (obesity, insulin resistance and hyperlipidemia), T2DM stage (hyperglycemia) and DN stage (abnormal renal functions) (all: P < 0.05) in the DN group. Serum TNF-α and IL-1β levels in the T2DM stage were significantly higher than those in the pre-T2DM stage (two: P < 0.05). Compared to the CTL group, renal nephrin, WT-1, TNF-α, IL-1β, eNOS and VEGF expression and hemodynamic parameters in the DN stage all showed significant differences separately (all: P < 0.05). Conclusion Increased serum and renal TNF-α and IL-1β levels played important roles in reducing renal nephrin and WT-1 expression levels, which may be related to the fact that the former affected renal VEGF/eNOS expression and blood flow parameters in the DN rats.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

TNF-α and IL-1β Promote Renal Podocyte Injury in T2DM Rats by Decreasing Glomerular VEGF/eNOS Expression Levels and Altering Hemodynamic Parameters

Wang¹,

Feng²,

Zhang³

et al. 2022

JIR

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“…In our previous study, we recruited HVs and patients with CKD stages 1–4 to assess inter-observer variability of the classical ROI-based method, and we found high reproducibility of both COT2* (ICC = 0.937) and MET2* (ICC = 0.910) [13]. In order to further assess the reproducibility of BOLD-MRI in patients with CKD stage 5, 10 patients with CKD stage 5 were recruited and analyzed by previous ROI-based method.…”

Section: Resultsmentioning

confidence: 99%

Correlation of Renal Oxygenation with Renal Function in Chronic Kidney Disease: A Preliminary Prospective Study

Yang

Liu

et al. 2023

Kidney Blood Press Res

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Introduction: Chronic hypoxia is prevalent in chronic kidney disease (CKD), and Blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI) provides noninvasive evaluation of renal oxygenation. This study aimed to explore the correlation of renal oxygenation evaluated by BOLD-MRI with renal function. Methods: 97 non-dialysis patients with CKD stages 1-5 and healthy volunteers (HVs) were recruited in the study. Based on their estimated glomerular filtration rate (eGFR), the patients were divided into two groups: CKD stages 1-3 (CKD 1-3) and CKD stages 4-5 (CKD 4-5) . We measured cortical and medullary T2* (COT2* and MET2*) values in all participants by BOLD-MRI. Physiological indices were also recorded and compared among three groups. Correlation of T2* values with clinical characteristics were determined. Results: The COT2* values were significantly higher than MET2* values in all participants. The COT2* and MET2* values of three groups were ranked as HV> CKD 1-3> CKD 4-5 (p< 0.0001). There were positive correlations between the COT2* values, MET2* values and eGFR, hemoglobin (r> 0.4, p< 0.01). The 24-h urinary protein (24-h Upr) shown weak correlation with the COT2* value (rs= -0.2301, p= 0.0265), and no correlation with the MET2* value (p> 0.05). Urinary microprotein, including urinary alpha1-microglobulin (α1-MG), urinary beta2-microglobulin (β2-MG), and urinary retinol binding protein (RBP), was showed strong correlation with COT2* and MET2* values. According to analysis of receiver-operating characteristic (ROC) curve, we obtained the optimal cut-point between HV and CKD 1-3 were “< 61.17 ms” (sensitivity: 91.23%, specificity: 100%) for COT2* values and “< 35.00 ms” (sensitivity: 77.19%, specificity: 100%) for MET2* values, whereas COT2* values (“< 47.34 ms”; sensitivity: 90.00%, specificity: 92.98%) and MET2* values (“< 25.09 ms”; sensitivity: 97.50%, specificity: 80.70%) between CKD 1-3 and CKD 4-5. Conclusion: The decline of renal oxygenation reflected on T2* values, especially in cortex, may be an effective diagnostic-marker for early detection of CKD.

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“…The impairment of PSV, MV, EDV, PI, and RI of the renal artery would affect renal physiology and functions. The progression of chronic kidney disease was accompanied by a decline in the renal artery blood flow velocity and an increase in renal artery resistance ( Yang et al, 2021 ). It is suggested that EDV and RI may be the best two indexes to evaluate renal function ( Abe et al, 2019 ; Di Nicolo and Granata, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Renal Protective Effects of Inonotus obliquus on High-Fat Diet/Streptozotocin-Induced Diabetic Kidney Disease Rats: Biochemical, Color Doppler Ultrasound and Histopathological Evidence

et al. 2022

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Diabetic kidney disease (DKD) is the current leading cause of end-stage renal disease. Inonotus obliquus (chaga), a medicinal fungus, has been used in treatment of diabetes. Here, we aim to identify the renal protective effects of chaga extracts on a DKD rat model which was induced by a high-fat diet and streptozotocin injection. During the total 17-weeks experiment, the biological parameters of serum and urine were examined, and the color Doppler ultrasound of renal artery, the periodic acid-Schiff staining, and electron microscopy of kidney tissue were performed. The compositions of chaga extracts were analyzed and the intervention effects of the extracts were also observed. Compared with the normal control group, the biochemical research showed that insulin resistance was developed, blood glucose and total cholesterol were elevated, urinary protein excretion and serum creatinine levels were significantly increased in the DKD model. The ultrasound examinations confirmed the deteriorated blood flow parameters of the left renal interlobar artery in the rat models. Finally, histopathological data supported renal injury on the thickened glomerular basement membrane and fusion of the foot processes. 8 weeks intervention of chaga improved the above changes significantly, and the 100 mg/kg/d chaga group experienced significant effects compared with the 50 mg/kg/d in some parameters. Our findings suggested that Doppler ultrasound examinations guided with biochemical indicators played important roles in evaluating the renal injury as an effective, noninvasive, and repeatable method in rats. Based on biochemical, ultrasound, and histopathological evidence, we confirmed that chaga had pharmacodynamic effects on diabetes-induced kidney injury and the aforementioned effects may be related to delaying the progression of DKD.

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Evaluation of Renal Oxygenation and Hemodynamics in Patients with Chronic Kidney Disease by Blood Oxygenation Level-dependent Magnetic Resonance Imaging and Intrarenal Doppler Ultrasonography

Cited by 11 publications

References 30 publications

TNF-α and IL-1β Promote Renal Podocyte Injury in T2DM Rats by Decreasing Glomerular VEGF/eNOS Expression Levels and Altering Hemodynamic Parameters

TNF-α and IL-1β Promote Renal Podocyte Injury in T2DM Rats by Decreasing Glomerular VEGF/eNOS Expression Levels and Altering Hemodynamic Parameters

Correlation of Renal Oxygenation with Renal Function in Chronic Kidney Disease: A Preliminary Prospective Study

Renal Protective Effects of Inonotus obliquus on High-Fat Diet/Streptozotocin-Induced Diabetic Kidney Disease Rats: Biochemical, Color Doppler Ultrasound and Histopathological Evidence

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