Is Kidney Stiffness Measured Using Elastography Influenced Mainly by Vascular Factors in Patients with Diabetic Kidney Disease?

Bob, Flaviu; Grosu, Iulia; Sporea, Ioan; Timar, Romulus; Lighezan, Daniel; Popescu, Alina; Şirli, Roxana; Buzaș, Roxana; Petrică, Ligia; Munteanu, Mircea; Schiller, Adalbert

doi:10.1177/0161734618779789

Cited by 23 publications

(24 citation statements)

References 38 publications

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“…Generally, vascular disease is regarded as one of the common pathways for the development of kidney disease. Previous studies have suggested an association between kidney stiffness and vascularity 17,24 . Progression of arteriosclerosis, expressed by brachial/brachial‐ankle pulse wave velocity and aortic augmentation index, might influence kidney stiffness 17,24 .…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have applied SWE imaging to evaluate renal fibrosis, either in transplanted or native kidneys. [23][24][25] Unlike SWE imaging in chronic liver disease, in which liver stiffness increased in advanced stages of the disease due to progressive fibrosis, the results for renal SWE imaging have been contradictory and inconsistent.…”

Section: Discussionmentioning

confidence: 99%

“…17,24 Therefore, it is possible that renal perfusion dominantly affects the kidney stiffness, more than tissue fibrosis does. 17,24 Another study conducted by Garcia et al showed that the loss of interstitial capillaries could induce lower perfusion pressures, effectively reducing renal stiffness and masking the increase in stiffness as fibrosis developed. 30 However, this explanation was based solely on blood pressure and arterial stiffness, with no histopathological correlation.…”

Section: Discussionmentioning

confidence: 99%

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Shear wave elastography accurately detects chronic changes in renal histopathology

et al. 2020

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Aim: Renal biopsy is the gold standard for the histological characterization of chronic kidney disease (CKD), of which renal fibrosis is a dominant component, affecting its stiffness. The aim of this study was to investigate the correlation between kidney stiffness obtained by shear wave elastography (SWE) and renal histological fibrosis. Methods: Shear wave elastography assessments were performed in 75 CKD patients who underwent renal biopsy. The SWE-derived estimates of the tissue Young's modulus (YM), given as kilopascals (kPa), were measured. YM was correlated to patients' renal histological scores, broadly categorized into glomerular, tubulointerstitial and vascular scores. Results: Young's modulus correlates significantly with tubulointerstitial score (ρ = 0.442, P < .001) and glomerular score (ρ = 0.375, P = .001). Patients with no glomerular sclerosis showed lower mean YM measurements compared to those with glomerular sclerosis. The mean YM increased as the percentage of interstitial fibrosis and tubular atrophy increased. The area under the receiver operating characteristic curve (ROC) for SWE in differentiating between mildly and moderately impaired kidneys was 0.702. Conclusion: Shear wave elastography accurately detects chronic renal damage resulting from glomerular sclerosis, interstitial fibrosis and tubular atrophy, using the optimal cutoff YM value of ≥5.81 kPa.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Shear wave elastography accurately detects chronic changes in renal histopathology

et al. 2020

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“…Two-dimensional shear wave elastography has been used mainly in diffuse liver disease for staging liver fibrosis in human medicine. Moreover, there are many studies about the 2D SWE application for differentiating between benign and malignant breast masses, differentiate between benign and malignant thyroid nodules, identification of the parathyroid adenoma and hyperplasia, and estimation of the kidney stiffness in chronic renal diseases (Barr et al, 2015b;Cosgrove et al, 2017;Golu et al, 2017;Lee et al, 2017;Bob et al, 2018;Kyriakidou et al, 2018;Liu et al, 2018;Cotoi et al, 2019;Grosu et al, 2019;Sãftoiu et al, 2019;Cotoi et al, 2020). In veterinary literature, 2D SWE was applied to distinguish malignant from benign conditions of mammary tumors and lymph nodes and to evaluate the margination and acute changes in stiffness of the ablated liver tissue after radiofrequency ablation in dogs (Glińska-Suchocka et al, 2013;Feliciano et al, 2017;Lee et al, 2018;Silva et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Two-Dimensional Shear Wave Elastography of Normal Soft Tissue Organs in Adult Beagle Dogs; Interobserver Agreement and Sources of Variability

Jung

Lee

et al. 2020

Front. Bioeng. Biotechnol.

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Shear wave elastography (SWE) induces lateral shear wave through acoustic pulses of the transducer and evaluates tissue stiffness quantitatively. This study was performed to evaluate feasibility and reproducibility of two-dimensional shear wave elastography (2D SWE) for evaluation of tissue stiffness and to examine technical factors that affect shear wave speed (SWS) measurements in adult dogs. Nine healthy, 2 yearold, adult beagles with the median weight of 9.8 kg were included. In this prospective, experimental, exploratory study, 2D SWE (Aplio 600) from the liver, spleen, kidneys, pancreas, prostate, lymph nodes (submandibular, retropharyngeal, axillary, medial iliac, and inguinal), submandibular salivary gland, and thyroid was performed in anesthetized beagles. Color map was drawn and SWS of each SWE were measured as Young's modulus (kPa) and shear wave velocity (m/s). The effect of measuring site, scan approach, depth, and anesthesia on SWE was assessed in abdominal organs by two observers independently. A total of 27 SWE examinations were performed in 12 organs by each observer. All SWS measurements were preformed successfully; however, SWE in the renal medulla could not be successfully conducted, and it was excluded from further analysis. Interobserver agreement of SWE was moderate to excellent in all organs, except for the left liver lobe at 10-15 mm depth with the intercostal scan. In the liver, there was no significant effect of the measuring site and scan approach on SWE. SWS of the liver and spleen tended to be higher with increasing the depth, but no significant difference. However, anesthesia significantly increased tissue stiffness in the spleen compared to awake dog regardless of the depth (P < 0.05). There was a significant difference in SWS according to the measuring site in the kidneys and pancreas (P < 0.001). 2D SWE was feasible and highly reproducible for the estimation of tissue stiffness in dogs. Measuring site and anesthesia are sources of variability affecting SWE in abdominal organs. Therefore, these factors should be considered during SWS measurement in 2D SWE. This study provides basic data for further studies on 2D SWE on pathological conditions that may increase tissue stiffness in dogs.

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“…Some previous studies showed that as one of the products in the process of long-term adverse glycation, HbA1c would describe the risk of not only arterial stiffness, but cardiovascular diseases [3], and the risk increases with the increasing HbA1c level. Many indicators diagnosing arterial stiffness or the progression of atherosclerosis are adopted [4][5][6][7] in different studies. Brachial-ankle pulse wave velocity (baPWV) and ankle brachial index (ABI) are two effective methods for the de nition of arterial stiffness.…”

Section: Introductionmentioning

confidence: 99%

Glycated Hemoglobin and Risk of Arterial Stiffness in Chinese Han Population: A Longitudinal Study

Han¹,

Kang²,

Zhang³

et al. 2020

Preprint

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Background: Glycated hemoglobin (HbA1c) is related to the risk and the progression of arterial stiffness, and such association can be found between fasting blood glucose (FBG), postprandial blood glucose (PBG), triglyceride-glucose index (TyG Index) and arterial stiffness. But the relationship in different studies is inconsistent, such longitudinal studies were sparse, and the comparison in effects of these four parameters on arterial stiffness was less conducted. We aimed to explore the longitudinal relationship between HbA1c and arterial stiffness adjusting for confounding factors in Chinese Han population and compare the risk effect of HbA1c, FBG, PBG, and TyG index on arterial stiffness.Methods: Data were collected from 2011-2012 and 2018-2019 survey in the Beijing Health Management Cohort（BHMC）study and 3048 participants were enrolled. Cox proportional hazard models were fitted to investigate the association between HbA1c, FBG, PBG, TyG index and arterial stiffness after adjusting for multiple general confounding factors. Results: Among the 3048 subjects, 591 were diagnosed as arterial stiffness during the follow-up. The adjusted HRs (95% confidence interval (CI)) for arterial stiffness compared with the lowest quartile HbA1c group were 1.22 (95% CI: 0.93-1.62), 1.52 (95% CI: 1.17-1.98) and 2.05 (95% CI: 1.59-2.63) of the three higher quartile groups respectively, which were higher than those of FBG, PBG and TyG index. Each 1% increasing of HbA1c indicated a 39% (HR: 1.39, 95% CI: 1.25-1.53) higher risk of arterial stiffness. Sensitivity analysis showed the consistent results treating the parameters as continuous variable. No significant association was found between TyG index and the risk of arterial stiffness, neither in continuous nor in polytomous form. The restricted cubic spline showed nonlinear association between HbA1c, PBG and arterial stiffness, but such association was not found for FBG and TyG index.Conclusion: HbA1c can be treated as an important risk factor of arterial stiffness. Individuals with higher level of HbA1c had higher risk of arterial stiffness compared with PBG, FBG and TyG index.

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Is Kidney Stiffness Measured Using Elastography Influenced Mainly by Vascular Factors in Patients with Diabetic Kidney Disease?

Cited by 23 publications

References 38 publications

Shear wave elastography accurately detects chronic changes in renal histopathology

Shear wave elastography accurately detects chronic changes in renal histopathology

Two-Dimensional Shear Wave Elastography of Normal Soft Tissue Organs in Adult Beagle Dogs; Interobserver Agreement and Sources of Variability

Glycated Hemoglobin and Risk of Arterial Stiffness in Chinese Han Population: A Longitudinal Study

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